Seven States Sue Over Health Worker "Conscience" Rule
Seven state attorneys general, Planned Parenthood, and the ACLU have sued to overturn the so-called "conscience" rule, which allows doctors, pharmacists, and other health care workers to refuse to perform procedures or dispense medication that conflicts with their beliefs.
Under the new regulation, federal officials can "cut off federal funding for any state or local government, hospital, health plan, clinic or other entity that does not abide by existing federal laws requiring them to accommodate doctors, nurses, pharmacists and other employees who refuse to participate in any care they consider objectionable on ethical, moral or religious grounds."
The rule, issued by President Bush's Department of Health and Human Services last month, is set to take effect the day before Barack Obama is sworn in (such "midnight regulations" have been common for outgoing presidents, particularly this one).
Although we think it's kind of silly to enter a profession knowing that part of your responsibilities entail doing things you're morally opposed to, we agree that it's a private business's right to refuse to dispense birth control or emergency contraception—and we look forward to not shopping there.
But as this rule only applies to federally funded health care providers, it raises two interesting questions: does allowing federally funded hospitals and pharmacies to fire or otherwise punish a health care professional who refuses to perform a procedure for conscience reasons violate that person's First Amendment rights, as HHS suggests? On the other hand, since birth control, abortion, and emergency contraception are all legal, does allowing a federally funded health care professional to refuse to provide these services to, let's say, a poor woman who relies on federally funded clinics, violate that woman's due process rights? We also worry about the potential for convenient bouts of conscience that only manifest themselves when minority women want birth control, or gay couples, or so on.
In any case, President-elect Obama has signaled that he intends to overturn the rule, although reversing a rulemaking would take months.
Lawsuits Filed Over Rule That Lets Health Workers Deny Care [WaPo}
Ensuring That Department of Health and Human Services Funds Do Not Support Coercive or Discriminatory Policies or Practices in Violation of Federal Law [HHS]
Editorial: A Parting Shot at Women's Rights [NYT]
(Photo: catheroo)
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Comments:
@courtneywoah - It doesn't have to be a field that conflicts with anyones' beliefs. That's the point of the law - it allows people to retain their jobs without being forced to perform actions which violate their religious/moral beliefs. I tend to think this issue is going to weigh out in favor of the workers, in the end, since, as the old saying goes, another person's rights only extends as far as the end of their nose.
While I think that it's complete BS that pharmacists, doctors, etc. are allowed to impose their beliefs on others by refusing to dispense certain types of medication, I don't have a problem with the federal government conditioning funding on complying with their rules. The Supreme Court has said in various Abortion funding cases that while the Federal Govt. (or states for that matter) can't prohibit early-term abortions, they don't have to pay for them. I think the same would apply to birth control and other legal medical services that the govt. occasionally takes on the obligation to pay for. I think it's bad policy, but I don't think it's illegal or unconstitutional.
I'm a vegetarian and have been for about 18 years. If I get a job at McDonalds, knowing full well that just about everything they sell contains meat, can I invoke this rule to refuse to prepare, sell, or serve anything meat-related because I find it objectionable on ethical and moral grounds? No, I would fully expect to get fired, and rightfully so, for refusing to do my job.
From the Hippocratic Oath:
"To practice and prescribe to the best of my ability for the good of my patients, and to try to avoid harming them."
"Never to do deliberate harm to anyone for anyone else's interest."
"To avoid violating the morals of my community."
I'm not a doctor, but if I was I wouldn't want the government telling me how to carry this out. If I felt murdering unborn children was deliberate harm for someone else's interest (which I do), then the government telling me to do this anyway is a clear violation of my oath.
I see this as the government's attempt to thwart doctors making their own moral decisions based on the oath of their office, and I don't like it. Just because the government is throwing money at something doesn't give them the right to make moral decisions for doctors.
"we agree that it's a private business's right to refuse to dispense birth control or emergency contraception-and we look forward to not shopping there."
Wow, that's the most libertarian thing I've read on the Consumerist in months. Congratulations.
If that's just what the Bush rule change allowed, then that might be all right. But It's much worse. Businesses can decide to sell certain products, but their employees could then in turn decide whether or not they wanted to distribute them, and the store would be prevented from threatening to fire them to get them to obey company policy. Total BS.
As a customer, it's one thing if you can decide "Okay, CVS doesn't carry my product, I won't shop there." It's another thing to walk into the store not knowing if the joker on duty will sell you that product or lecture you for asking for it.
As soon as they get rid of the "conscientious objector" exemption for liberals who join the military just for the money and scholarships but then balk when they are actually called to duty then I'll sign up for the whole "shouldn't be working in a field that conflicts with your beliefs in the first place" line being applied to conservatives. Let's not be hypocrites here. Either allow conscientious objectors in all fields or no fields.
There is no way this will stand in a court of law. If the courts can kill it before Obama does, then all the better.
@runchadrun:
Try telling that to all those Muslims that work at Super Targets in Minnesota & won't handle packages of bacon.
This is clearly aimed at abortion pills, emergency contraception, etc. But how far will they allow it to go?
What if I disagree with someone getting in vitro fertilization and refuse to dispense their hormone medication so they'll adopt instead?
What if I'm a Scientologist and don't agree with psych-related meds so I don't have to give people their Zoloft?
What if I know a man is using Viagra to cheat on his wife? Can I refuse to dispense his medication?
What if I am against sex that's not for procreation? I can refuse to give out birth control, or even condoms from behind the counter?
It's ridiculous and needs to be stopped. These people are professionals and it is not their job to proselytize their beliefs nor to enforce any kind of moral code on their patients.
Thats nonsense, I fully support the rights of the doctors and nurses on this one. are you saying that a catholic or a jew has to give up their religion to help their peers? if they dont believe in birth control, the patient still has plenty of options.
and weak comparisons to vegetarians aren't applicable, people aren't meat and the choice to be a doctor isnt the same as only eating vegetables
consider this, I find abortions perfectly acceptable, not everyone does. does that mean that anyone who objects to abortions cannot work in health care? whose protecting the rights of the doctors who are getting screwed anyway by everyone else? We already have a fatal shortage of nurses, making things worse for the already overwhelmed field of health care is disaster for everyone
Dude, I was just about to post THE EXACT SAME THING. I am also a vegetarian, and I was going to say how long would I keep my job if I worked at McDonald's and refused to serve anyone a hamburger because it conflicted with my beliefs? Would any court of law support my position? I hope not.
A pharmacist has no right to make my medical OR moral decisions for me. If I want medical and moral guidance, I'll go to doctors and I guess clergy. Not the guy behind the counter at Walgreens.
@GuinevereRucker: it has nothing to do with morality, really. Pregnancy is a health issue, and doctors are obligated to take care of health issues for their clients. So long as the government licenses doctors to practice, they have the right to call the shots on what behavior violates the license.
In Massachusetts it is illegal for ANY pharmacist to refuse Plan B to anyone over 18 who comes in for it.
This would make a federal rule trumpting this law. Obama will like repeal it, but still.
Gotta love how Wal*Mart uses sweatshop labor, is vehemently anti-union, wouldn't pay its women equally until it was sued, and disregards its effect on small businesses. And so on and so forth.
But birth control? How immoral!
Doctors should be allowed to refuse to personally dispense what conflicts with their beliefs. As GuinevereRucker said, to do otherwise would conflict with the Hippocratic Oath. But it should be the company's policy to ensure that there is always someone on staff who can and will dispense such medication or treatments, because some people need them. I don't want to be told that I have to drive 10 miles out of my way just because they can't handle staffing properly.
It's flat-out refusing to treat people/dispense meds that's absolutely absurd. And hey, if companies let this happen, they DESERVE to lose federal funding; that money is supposed to go in service of the people, not to go against it.
This elevates any opinion/belief as being superior to the medical needs/desires of the consumer. Sure, it's easy to say "someone who objects to contraception shouldn't have to dispense Plan B" but does someone who "objects" to homosexuals decide no one gets the HIV cocktails until they prove they got it "innocently"? Can a pharmacist refuse to dispense treatment for STDs if they disapprove of premarital sex? Can a non smoker say, "sorry, no treatment for your lung cancer, you chose your lifestyle, not me." If, ethically, I think this customer is a scumbag, can I refuse to hand over the blood pressure medication?
Sadly, we won't hear stories of people saying "Ohh, I see you are a religious extremist and I think you are morally repugnant, therefore no Paxil for you." The only people who want to make it harder for others to get health care tend to rely on religious beliefs to back them up.
I'm pretty sure there aren't any pharmacies performing abortions. If you disagree with the ethics of your employer then you're free to stop cashing their checks.
The government licenses doctors and pharmacists. If a doctor or pharmacist violates the standard of care or their license terms, then they should have that license yanked.
If this law passes, then insurance companies may choose not to work with doctors who don't offer the standard of care that their clients expect.
Yet another mess created by religious activists. This law wasn't put in place to solve a problem, it was put in place to allow a small nasty segment of society to shove their dogma on other people.
When you have religious activists purposely going into certain fields of health care with the intent of influencing people's access to medical services you have a problem. There have been certain extremist churches encouraging members to become doctors, pharmacists, nurses and lawyers specifically to inject their religious ideas on everyone else.
@GuinevereRucker:
I think your confused as to what the new law says. The FEDERAL government will cut off funding to hospitals, etc. that REFUSE to allow doctors, etc. to abstain from providing care they object to.
I'm fine with the "Conscience" rule, so long as it gets an addendum that lets me punch anyone who invokes it in the face, no consequences, no questions asked. If not, can it.
"does allowing federally funded hospitals and pharmacies to fire or otherwise punish a health care professional who refuses to perform a procedure for conscience reasons violate that person's First Amendment rights, as HHS suggests?"
No, for several reasons.
1st amendment is not a blank slate to not do your job.
1st amendment stops when your action interferes with others right to be free from religious interference.
@DMXParsons:
CVS, etc. isn't affected by this. It only applies to establishments that receive Federal funding, not private businesses. It applies to hospitals, hospital pharmacies, etc. CVS is still free to fire the person for refusing to do their job.
I suppose the ruling would also apply to those that administer lethal injection or help with capital punishment in any way.
Aha, take that conservatives.
@GuinevereRucker: "If I felt murdering unborn children was deliberate harm for someone else's interest (which I do), then the government telling me to do this anyway is a clear violation of my oath."
How about wasting all those sperm that could have produced a beautiful human life? Can I, as a medical provider or pharmacist, refuse to provide birth control on those grounds? Watch out, or you might find that the slope is a lot slipperier than you expected.
@morganlh85: So you can@morganlh85: So you said that you have the right to have abortion but it not alright for a doctor to said no to doing because has a right. Double standard?
I want to become an EMT so when my ambulance pulls up to some nice couple needing acute medical care, I can refuse them because they're driving a SUV - planet-killers and all. And I want to be protected, nay, lauded for my "conscience" and they slowly, terminally, bleed to death at my feet.
I don't see the difference between that and this.
@morganlh85: i agree. i mean how many people are they allowed to refuse? and it wouldn't surprise me if some crazy Scientologist got a job just so they could deny everyone their medicine and give a big lecture on their beliefs. its not a worship center its CVS.
@GuinevereRucker: This rule isn't about protecting the rights of health care workers. It's about limiting the choices of people who rely on federally funded hospitals, clinics, and pharmacies for their primary care needs.
If an employee's beliefs don't agree with the services that their employer expects them to provide, they can find another job. I have generous health care coverage, a good job, and a car - I can keep looking until I find a provider who will meet my needs. People who depend on community health centers and local health departments for their care often do not have their luxury.
@GuinevereRucker: Just because the government is throwing money at something doesn't give them the right to make moral decisions for doctors.
Yes, it does. The government funds the business and, as such, dictates how that money is used.
If it conflicts with your believes, find a job more in line with said beliefs.
He who has the gold, makes the rules. Sorry about your luck and misguided view on abortion.
@courtneywoah: That is not fair at all! Many people have to make hard choices regarding their conscience. An example is military. A Military is good and can be used to protect a civilian population. Imagine if your president declared an illegal war and you know that if you fight this war you will be tried for war crimes. Do you fight, or refuse?
You just said, "you shouldn't be working in a field that conflicts with your beliefs in the first place."
Am I the only one that finds this to be stupid? Some of these doctors and nurses have been in this profession for 30 years or more...Soon they may be able to be fired for actually having morals? Awesome...
It would be a different story if journalists were forced to print lies or else be fired, wouldn't it?
@Jakuub: I'd like to up the ante by inserting a taser rider. Perhaps it will shock some sense into them.
Awesome photo! Great find!
This law hurts the poor and minorities the most. Thanks George!
@dragonprism: "Doctors should be allowed to refuse to personally dispense what conflicts with their beliefs. As GuinevereRucker said, to do otherwise would conflict with the Hippocratic Oath."
Really? Can a Jewish doctor refuse to treat a Muslim on the grounds that she believes that Muslims generally want Israel to be destroyed and thus she would prefer that the Muslim die? What if I'm a Christian doctor who believes that only Christians should get lifesaving medical treatments? Or better yet, only "good Christians"?
And isn't the "patient" in this situation the person who's seeking the medical treatment? I'm not sure how "ignoring my patient's wishes" becomes treatment "for the good of my patients." Do you really mean that a doctor can say "I consider every unborn fetus to be my patient, and thus my relationship to them trumps any concern about providing medical care to the human host body."
cromartie: You government also founds judges and courts, does that give it the right to dictate the course of a trial?
@dallasmay: it totally sucks when your president declares an illegal war. However, one should be aware that there is a possibility this could happen before one signs up for the military. Is it fair? no, do you have a choice? yes.
That's actually probably the best idea on the situation I've heard... but as a law, not as a "policy." Yeah, you can refuse to give someone BC, but your coworker will just give it to them. And it creates more jobs... everyone's happy except the people who have to pay for the new employee.
We also worry about the potential for convenient bouts of conscience that only manifest themselves when minority women want birth control, or gay couples, or so on.
Gay couples wanting birth control? Am I missing something or is everything I've thought up until now wrong? Oh no...I think I have to make a phone call...
Refusing to supply something such as birth control pills could be a violation of the hippocratic oath and put some women at risk for harm. Many women are prescribed birth control for medical reasons unrelated to birth control.
Why does the federal government think that one person's morals trumps another's need for medical care?
@dallasmay: If you have a fear of actually being tried for war crimes, you probably have larger issues surrounding your choice to be in the military in the first place.
In health care, there is no excuse. There are lots of jobs out there for health care professionals. If you don't feel comfortable prescribing birth control, don't take the job in a women's health clinic.
I'm seeing a lot of black and white thinking along the lines of "don't enter the profession if you know you will have to do things you consider unethical or immoral", which is a bit disturbing. This might work for a vegetarian considering working at McDonald's, but the logic does not extend into the health care field.
Abortions, Plan B, and other controversial family planning related treatments are but a small part of the specialty that is OB/GYN or "Women's Health". There are many physicians practicing GREAT Medicine in this specialty who refuse to participate in elective abortions because they believe it fundamentally violates the Hippocratic Oath. Does that somehow render them incompetent to deliver babies, treat STDs, screen for cancers and provide treatment, or any of the other services they provide? What some of you are suggesting (don't go into Medicine if you morally object to any of your job duties) is tantamount to throwing out the baby with the bathwater.
As a physician (thankfully not OB/GYN) I can assure you that the medical profession WILL NOT stand for the government dictating to us what is acceptable and what is not in terms or morals/ethics in our practices. If this gets overturned and docs employed in federally-sponsored clinics/programs actually do come under pressure to do things they find morally objectionable, you will soon see docs leaving such practice situations in droves, which will only be bad for the patients served by these facilities (Physician jobs are not at all difficult to find, and there are shortages of OB/GYNs everywhere-no reason why any doc needs to stay in less than favorable working conditions, jobs are plentiful).
The slippery slope is frightening: what happens when euthanasia is legalized, is the right to object to killing another human being also going to be taken from us?
@morganlh85: And god, what about all the gynecologists who feel that promiscuity is bad and thusly won't treat their patients for STDs because its the Wrath of God.
Slippery Slope for sure!
@Jakuub: Just use standard business lingo and disclaimers. Corporations think they work...
"By refusing to fill my birth control prescription, I hereby reserve the right to punch you in the face. In no way am I responsible for any injury that arises. Refuse at your own risk. By conducting this transaction, you hereby agree to these terms and condititions. All complaints will be taken very seriously."
good! you shouldn't be working in a field that conflicts with your beliefs in the first place. Seriously.