Broader medical refusal rule may go far beyond abortion

[RamboLiberal]

Source: LA Times

Reporting from Washington -- The outgoing Bush administration is planning to announce a broad new "right of conscience" rule permitting medical facilities, doctors, nurses, pharmacists and other healthcare workers to refuse to participate in any procedure they find morally objectionable, including abortion and possibly even artificial insemination and birth control.

For more than 30 years, federal law has dictated that doctors and nurses may refuse to perform abortions. The new rule would go further by making clear that healthcare workers also may refuse to provide information or advice to patients who might want an abortion.

It also seeks to cover more employees. For example, in addition to a surgeon and a nurse in an operating room, the rule would extend to "an employee whose task it is to clean the instruments," the draft rule said.

The "conscience" rule could set the stage for an abortion controversy in the early months of Barack Obama's administration.

-----

Health and Human Services Department officials said the rule would apply to "any entity" that receives federal funds. It estimated 584,000 entities could be covered, including 4,800 hospitals, 234,000 doctor's offices and 58,000 pharmacies.

Read more: http://www.latimes.com/news/nationworld/nation/la-na-conscience2-2008dec02,0,7013690.story

[GreenPartyVoter]

1. *sigh* Heaven help anyone who is surrounded by such "medical care" places and

who has no other option but to use them.

[patrice]

2. I wonder if that extends to the various uses of Morphine in end of Life care. Probably not. nt

[enlightenment]

12. Given the vague wording, why couldn't it be extended to

areas beyond sex and reproduction?

Why couldn't a Jehovah's Witness refuse to handle blood products, citing a fear of personal contamination?
Or a Mormon refuse to prescribe caffeine (a not uncommon prescription for kids with ADD)?
What about organ transplants - some religions insist that you have to be intact at death. A believer could refuse to participate in that surgery on moral grounds.
How about claiming that your religion is opposed to miscegenation (nasty word, but that's what they'd use) and refusing to treat mixed-race couples or their children?

I suspect that in end-of-life cases, it will definitely rear it's nasty head, since most people seem to object to allowing the elderly and terminally ill death with dignity on their own terms.

[Hell Hath No Fury]

18. Exactly.

The wording leaves this issue so wide open that a "christian" doctor could refuse emergency treatment for a gay person, an unmarried woman, or variety of other people based on a whole host of issues.

I can hardly wait for the first health care providor to refuse some right-wing "christian" a service because they find it morally objectionable to treat bigoted assholes! :D

[nashville_brook]

24. hell, doctors have been refusing to treat pain for years.

[MountainLaurel]

25. That's exactly my concern n/t

[meegbear]

3. Next, people with HIV ...

"this is God's punishment to them".

[underpants]

4. GOD'S PEOPLE don't need comprehensive competent health care

O8)

[Deep13]

6. This will help them get to heaven sooner!

Hallalujia!

[Deep13]

5. So why do the rest of us have to suffer for the religious objections of a few?

This should make it clear that the anti-abortion people are after all forms of birth control.

[Phred42]

8. Bacause they are better organized and funded

:shrug:

[Blaze Diem]

7. "It was God's 'will' to put that cyst on your ass, Mr Limbaugh, I'm not touching it".

It is the "Christian" government.

[librechik]

9. Viagra. Lots and lots of free viagra for everybody

and fuck all the females. Apparently.

[VPStoltz]

10. What next? No cough medicine because you caught it by kissing your gay partner?

These people are frickin' insane.

[kiva]

11. From Salt Lake Weekly. com in September...

http://www.slweekly.com/index.cfm?do=article.details&id=29523C53-14D1-13A2-9FB5DFE2037C99B6

It’s mad scramble time. The End cometh. With just four months left in the Bush administration, presidential minions are leaping over each other to dump dogma on America before Inauguration Day 2009....
You may remember Leavitt as the governor who held what key staff members came to know as “early-morning seminary meeting sessions” in the tax-funded Governor’s Mansion. They laced policy discussions and tweaked his speeches with references to the Book of Mormon and another LDS holy text, The Doctrine & Covenants. Not surprising, then, that Leavitt is deeply concerned with threading similar themes through his government-funded blog. He wonders aloud in the same Aug. 11 post why family-planning advocates would have any anxiety over his proposal. “Is the fear here that so many doctors will refuse that it will somehow make it difficult for a woman to get an abortion? That hasn’t happened, but what if it did? Wouldn’t that be an important and legitimate social statement?”

No, that 'social statement' would be that those Americans really don't believe in the First Amendment.

[yardwork]

13. This would give health care providers the right to refuse services to anybody.

"Religious beliefs" could be used to deny health care to anybody for any reason.

[bemildred]

14. I don't want unwilling providers doing any procedures on me. nt

[KnaveRupe]

15. Are Scientologist pharmacists allowed to refuse to dispense antidepressants?

Are 7th-day Adventist doctors allowed to refuse to give ANY medical treatment?

This is asinine.

If you have a problem performing the duties of your job on religious grounds, find a new job.

If I'm an Orthodox Jew, I'm not going to go get a job at Porky McShrimp's Ribs and Shellfish Emporium restaurant, then refuse to wait on any tables because I find it offensive.

If I'm a Hindu, I'm not going to get a job at a slaughterhouse, then refuse to kill cows.

If I'm an Orthodox Mormon, it would be stupid of me to take a job as a barista at a Starbucks and refuse to sell coffee.

If I'm opposed to abortion on religious grounds, why would I take a job at a facility that performs abortions? If I'm opposed to dispensing birth control on religious grounds, why would I take a job as a pharmacist?

Hey - here's an argument to throw at any fundies espousing this: tell them to exercise a free-market-based solution! They are free to open up their own Christian abortion clinics that don't perform abortions, and compete with those clinics that DO. They can open up their Jesus-based pharmacies that refuse to sell condoms, sponges and birth-control pills, and compete against those businesses that DO.

I mean, Jesus *is* a Laissez-Faire capitalist, right?

[Occulus]

60. "f I'm opposed to abortion on religious grounds, why would I take a job at a facility..."

What needs to be clearly understood is that reichwing christians take exactly those jobs with the express and explicit purpose of making sure such procedures are performed less and less prescriptions they find objectionable are filled. They take the jobs to make certain the jobs are not done, and if they're fired for doing so, they can sue on religious discrimination grounds.

Ultimately, they want religion- their religion- in control of both healthcare and education. This is why they have their people on school boards, too- to make certain the jobs are done or the policies are enacted in accordance with their religious beliefs.

They will "save" you- whether or not you want them to- and they will do so on their terms. This often ends with punishing those who don't want to be "saved".

[pattmarty]

16. AND, "they" try again to turn the clock back to oh, say, the 1800's.

[snake in the grass]

17. If Bush can just go ahead and pass this...

...why can't Obama simply reverse it? I hope he does. I know there are so many problems to deal with but I would put this policy on the priority list.

[hunter]

19. Imagine an "abstinence only" general practitioner.

I wouldn't let such a doctor anywhere near a teenager, maybe I wouldn't let them near anyone...

Doctors have to deal with people and situations as they encounter them -- they can't just say "God Bless You, God Bless America, don't have sex outside of marriage and don't have gay sex at all," and then move on because their own delicate conscience and fragile religious sensibilities prevent them from facing some problem directly.

The streets are sometimes mean and messy, and doctors are often on the front line. What's best for the patient always comes first, even when it conflicts with the doctor's religious beliefs. If it is beyond a doctor's capacity to deal with some sort of problem for any reason at all, then it is the doctor's obligation to refer the patient to another doctor who can deal with the problem.

There is also a point where someone shouldn't be in the medical professions at all, for example pharmacists who refuses to dispense birth control, general care practitioners who can't talk about sex, or nurses who expresses their homophobia or racism by lowering their standard of care for certain patients.

Whenever I've worked in medicine employers have told me directly what they are about. Some of the big concerns in lab work are prenatal testing for Down Syndrome and similar disorders because the results of these tests are often the basis of decisions to terminate pregnancies. If a person can't deal with that, they don't get those jobs.

In smaller towns and remote regions it is especially important that medical professionals are not especially restricted by their religious beliefs because they are often the only medical resources available to people who do not share those beliefs.

We can't let a majority trample the rights of a minority which is why this Bush Administration rule is wrong.

[Trillo]

20. Everyone should have this right

Not just doctors and certain healthcare workers.

Short of giving EVERYONE the right to consciously object to anything in their job description, then they can just tell their boss "I quit" and lose their paycheck, or they can perform the task they're paid for just like everyone else.

It seems the last thing in our modern civilization needs is more special treatment for the few.

I'm sure that if everyone had this right, the world would be a happier, if monetarily poorer place. But giving that right to a special selected few that are already privileged in many ways seems morally and ethically objectionable.

[uppityperson]

21. k&r for a bad idea. How about if you can't comply with the job description, you quit.

This is way too broad to be allowed.

[LynnTheDem]

22. How about Jews? And blacks?

If Jews or blacks are something doctors, first responders etc have a "right of conscience" against, can they "refuse to participate"?

Liberals? Actors? Scientists?

When do we go from "procedures" and "prescriptions" to race and color "conscience"?

[knitter4democracy]

23. So, how does this affect state licensure?

Medical practices and such are governed by state laws and state health depts., so how would this play out on the state level?

I foresee this going to court first.

[MadMaddie]

26. They are opening up a can of worms

What about single mothers, children of gay parents, and all of the other types of people mentioned already.

Screw * and his administration, their only goal was to wreck America. This is their legacy, let us always make sure that to remind them of it every chance we get.

[ksimons]

27. hope the legislature takes this one out, first time around

there will be attempts to filibuster I bet, but this would be medical terrorism, not knowing if when you go to a hospital whether you'll be treated or that your 'condition' meets with their 'approval'

Sickening

[Zhade]

28. Or refusing to treat GLBT PEOPLE?

This is so fucking wrong.

[grilled onions]

29. What About The Patients Rights?

Every time one of them refuses because of their rights they are trampling on mine. Today it might include the scrub nurse--tomorrow it may include the janitor! It isn't bad enough that we have to jump thru hoops thanks to the insurance industry and their powers but we also have the fanatics who have jumped on the bandwagon and they seem to work at every kind of facility where they can wield their beliefs upon others. It's getting very scarey out there!

[OKNancy]

30. kick

[kpete]

31. White House preparing health care bombshell

Source: The Age, Australia

White House preparing health care bombshell

* David Savage, Washington
* December 3, 2008


THE outgoing Bush Administration is planning to announce a broad new "right of conscience" rule permitting medical facilities, doctors, nurses, pharmacists and other health care workers to refuse to participate in any procedure they find morally objectionable, including abortion and possibly even artificial insemination and birth control.

For more than 30 years, federal law has dictated that doctors and nurses may refuse to perform abortions. The new rule would go further by making clear that health-care workers may also refuse to provide information or advice to patients who might want an abortion.

It seeks to also cover far more employees. For example, in addition to a surgeon and a nurse in an operating room, the rule would extend to "an employee whose task it is to clean the instruments", the draft rule said.

The move could set the stage for a divisive abortion controversy in the early months of the Obama administration. During the campaign, President-elect Barack Obama said there was a "moral dimension to abortion" that cannot be ignored, but he also promised to protect the rights of women who seek abortion. And while the rule eventually could be overturned by the new administration, the process could take months of wrangling.

Read more: http://www.theage.com.au/world/white-house-preparing-health-care-bombshell-20081202-6ppr.html

[msongs]

32. article on front page of LA Times today on the same subject. why cannot the new

administration just create a new rule outlawing the old one. what's the big deal with this rule crap?

Msongs

[jobycom]

41. They don't care about the rule. They want the controversy.

They want Obama and the Democrats in Congress to have to make decisions and cast votes on abortion, so the next round of Republicans can use the issue for fundraising and election purposes. Also, if Obama is tied up in controversy, some Dems will be less likely to back him, and he'll be weaker on controversial issues like health care. Every voter they can turn against Obama weakens his chance to accomplish his goals, and strengthens the Republicans.

They did much the same thing to Clinton over gays in the military and gay marriage in 92, and again in 96.

Not saying this will hurt Obama, just that that's what BushCo wants to happen.

[Bozita]

46. Divide and conquer, the Republicon way of doing things. First step is controversy.

[Warren Stupidity]

33. scorched earth

and meanwhile, as usual, our side is reaching out to meet the intolerant theocratic fascist party half way. The center is now just slightly left of outright fascism.

[gblady]

34. Rachel....

had a good discussion about this BS on her show tonight...

Another thing that Barack will have to undo...(hope he can)

[aquart]

49. Or the public will. Or the doctors will.

People can demand treatment from doctors who are NOT idealogues. If every health care professional is subjected to questions on this subject, THEY will be the ones to fix the problem.

Doctors and pharmacies can be boycotted like anything else.

[cpamomfromtexas]

58. That's an excellent idea, hey mods, how about setting up a boycott list by state and city?

[aquart]

61. Not even.

People can go where they choose. But it's life-threatening to have a doctor who's basing your care on his ideology. We need to be fully informed.

[gblady]

35. hiccup!

[jwirr]

36. I thought they had to have everything done 60 days before he leaves

office - it is 49 days.

[rpannier]

37. When I read your Subject Line

I thought the story was going to be about a bomb they had built to use on people who were sick but couldn't afford health care.

The true story is not much better

[BrklynLiberal]

38. Isn't there some way Obama can undo this hideous act when he is

sworn in???

[DRoseDARs]

39. Could Obama leave this one on the books? Maybe write another rule revoking the medical license...

...of any "medical facilities, doctors, nurses, pharmacists and other health care workers" who choose to put their personal religious beliefs ahead of their responsibility as medical practitioners. They don't want to fulfill their obligations? Fine, don't practice medicine. :shrug:

[soothsayer]

40. no problem. just fire them like the air traffic controllers.

[bluestateguy]

44. That would be cool

Imagine Obama saying to a bunch of religious fanatic nurses and health care workers, "do your jobs, or be terminated" and then ceremoniously canning them when they all refused to comply.

[libnnc]

47. ATCers didn't strike because Jeebus told them to.

Apples and oranges.

[Hekate]

42. This is a real poison pill. In order to protect women, Obama has to have a fight immediately...

A real divisive culture wars type fight, right off the bat. Thank you so very much W, you evil git you.

I scanned the article on the front page of the LAT this morning and it looks like Bush the Evil will also permit those who object to medical procedures to flat-out refuse to discuss them and refuse to refer patients to those who will.

This is the Global Gag Order coming home to roost. He reinstated that on his first day in office, and now close to the end he brings it on home.

How much more harm does he have up his sleeves in the waning days of his residency? How many more trip-wires and booby traps and pitfalls are waiting our new administration, courtesy of that sonovabitch?

Hekate

[MrModerate]

48. But most people will see this as exactly what it is . . .

A deliberate attempt to stir shit. And most people don't support health professionals cramming their fairy tale fantasies down patients' mouths.

This will cause a stir, perhaps, but Obama will win points by rubbing it out.

[EFerrari]

51. What an evil bastard he is. When the right starts waxing poetic,

we have to put in at least A WEEK writing about how much he hurt women and their families. We need to push and make the work go viral so this man can NEVER be rewritten into some kind of benevolent saint. :grr:

[bluestateguy]

43. At a certain point Obama will have to disregard federal law and reverse these Bush orders by fiat

I don't give a damn what the law is. Sometimes what has to be done has to be done because it is simply right for the country.

[DogPoundPup]

45. As if the Shrub Administration hasn't already caused ENOUGH headaches

and CRISIS situations for the Obama administration to have to contend with.

[SnowGoose]

50. Slow-coding

When my spouse was in medical school, there was a discussion of what they called a slow-code. The idea being that when, say, a drunk driver (or wife beater or child molester or whatever) is on the brink of death, sometimes doctors & nurses have the inclination to... well... not try very hard.

Although apparently it happens, I was incredulous at the notion of doctors letting someone (even someone repulsive) die due to inaction (or rather slow action).

I wonder if the "culture of life" Bush will be providing doctors with cover to do this openly: (e.g. "I'm morally opposed to treating a drunkard"). Hey, "any procedure" is a pretty broad spectrum, and this kind of thing is exactly why we want our healthcare providers to separate their personal from their professional opinions. Someone who can't do that should probably be in a different line of work.

[Hekate]

55. You are absolutely right. Existing laws and existing medical ethical standards provide for that...

... or at least they did before Bush and his religious loonies came to power.

Any pharmacist should be required to dispense any legal medication on presentation of a valid prescription. Otherwise they should go find another job.

With doctors it's harder because they specialize, and you do not want a plastic surgeon whose last 10 years of experience is boob jobs and face lifts being required to perform other surgeries on demand. But again, existing medical standards take care of that via referrals to specialists.

As far as I am concerned, with few exceptions, doctors and nurses should be required to perform medical procedures and treatments that are (a) legal and (b) within their area of training. The exceptions are those who work in specifically religious hospitals and clinics, and even then there are some things that need to be universal by law, such as giving Plan B to rape victims without a single demurral, and being required to make meaningful referrals.

Hospitals, clinics, and doctors who have religious qualms should be required to state that up front -- and I mean really up front, like a big sign in the lobby and in their ad in the Yellow Pages. Otherwise, if they work in a public or otherwise nonreligious hospital or clinic they need to do their freaking job as regards (a) and (b) above.

Hekate

[moggie]

52. This is such an important measure that it took them eight years?

How transparent can you get?

[starroute]

53. What if a woman has a life-threatening complication of pregnancy?

Does a fundie doctor have the right to not mention that an abortion would be the most certain method of preserving her life, her health, and her ability to have future children? Does he have the right to sigh and tell her she just has to take her chances on the outcome and not even mention that another doctor might offer a different opinion?

And does the rule prevent medical facilities from refusing to hire people who refuse to perform the services offered by those facilities? A while back I saw something suggesting that it did. Would that mean an abortion clinic could be forced to hire people who refused to lift a finger to do anything involving abortions? That would be strange indeed.

There are some very bizarre legal and moral paradoxes here, and it would be nice to see them torpedo the whole things.

[NBachers]

54. So does that also apply to

Ambulance drivers and paramedics who find people of color objectionable? What if it's one o' those filthy illegals bringing disease into Amurka?

Judges who support pseudo-christians over the un-saved?

Medical staff who object to AIDS patients?

Hospitals that don't approve of the "gay agenda?"

Houses where trick-or-treats are only available when parents agree with the politics of the homeowner?

[orleans]

56. and on the upside medical personnel can now refuse dick "crash cart" cheney

a heart transplant--as a "right of conscience"

[McCamy Taylor]

57. You might be required to hire a Scientologist pharmacist---who would refuse to refill psych meds.

Or you could be forced to hire Scientologist nurses or office staff who would turn around and refuse to take calls or call in refills for anyone who needed their antidepressants refilled.

You would be forced to hire a nurse who refused to talk to a male patient unchaperoned (for religious reasons) and then you would have to hire another or nurses aid to take up the slack for the things that she said she had she had a moral objection against doing. Or say your nurse believed that all gays were criminals and she would not have anything to do with them---you would need someone else for the gays.

If your staff did not agree with vaccinating children, then you could not force them to give the kids shots---you would have to hire someone else to it.


From what I have heard, medical employers would have to treat moral objections like disabilities---they would have to hire people who were totally unsuited for the job if they were qualified in all other ways except that they had moral objections to performing the duties of the job (!!!!). So, for instance, Right to Lifers could apply at Planned Parenthood and then refuse to do almost anything except counsel about abstinence and there would be no way to fire them.

Some one please correct me if I am wrong. It sounds like they plan to drive family planning operations out of business by infiltrating them with a bunch of moles who will get on the payroll and then do no work.

I think we should make the same law for the army. Say that the military can not refuse people just because they say that they will not fight or kill. So we all get on the payroll and refuse to fight. Viola! No more war.

[HopeHoops]

59. 2030 history book, Chapter 43 - "How to Absolutely F*** up EVERYTHING in Eight Years"