Oh God DHHS no.

[xenologer]

The Bush administration has officially proposed a rule to the Dept. of Health and Human Services that doctors can refuse to treat patients if their consciences protest for any reason. Basically if they dunwanna, you don't get medical care.

Send an email to consciencecomment@hhs.gov, with the subject line "provider conscience regulation." They are publishing these comments right now, because it is in a 30-day public comment period. This is an absolute emergency. Don't let the misogynist religious whackos be the only voices DHHS hears. Say something. Just send an email. Otherwise, after thirty days, this rule goes into effect.

Really. It does. This is going to happen. Please tell them you are NOT falling for this bullshit, and that you are NOT going to let fundamentalists speak for you.

Here's what I'm saying.

Doctors do and always have had the freedom of conscience to choose not to provide certain kinds of medical care. This is the choice they make in medical school when they're investing tens of thousands of dollars to become educated and licensed. If they are not ready to fulfill the obligations of their chosen profession, then just like anyone else who doesn't want to do their job? They shouldn't be doing it. Doctors need to provide patients with medical care. End of line.

Here's the problem. Doctors should not be the ones to decide which patients "deserve" the standard of care they are coming to receive. Those who say that this ruling is not about denying women access to birth control are either gullible or lying. Here's how I know it's about denying women health care.

One: This is clearly about allowing doctors to refuse to perform abortions for patients who request them. Considering that 87% of counties in America don't have an abortion provider, this puts rural women at a serious disadvantage when they need medical care. Why does this statistic matter? Because if the one doctor within reasonable range of a woman in need refuses to treat her, she may not be able to find another, particularly considering that this proposed rule does not include provisions for women who have been refused. Not only can her doctor say no, but he is not obligated to refer her to a physician willing to provide her with an abortion.

Two: This becomes truly scary when you think about the fact that DHHS wants to change the definition of "life" to "at fertilization" rather than "at implantation." These are both pretty damned arbitrary classifications considering that a fertilized egg is less of an independent organism than the gut flora living in my large intestine (and which I am allowed to slaughter at will with every antibiotic treatment I undergo). Why is this scary? See point three.

Three: Non-barrier methods (basically anything but a diaphragm or condom) works at least partly by preventing implantation. It prevents the fertilized egg from sticking to the inside of your uterus so that it never has a chance to start getting nourishment from your body. It's flushed out like any unfertilized egg, and your body does this on its own. What this means is that any non-barrier method that interferes with implantation will be classified as an abortion, giving doctors a perfect airtight legal excuse to deny women these prescriptions because a moral imperative the patient obviously does not share (or she wouldn't be asking for contraceptives) dictates that she doesn't need contraceptives after all.

If you are not ready to provide the services of a physician, don't become one. If it's against my religion to dance in public, I should not dream of Broadway. If I believe that rum is the devil's poison and that Prohibition should be re-established, I should not aspire to become a bartender. If it's against my conscience to provide medical advice or procedures to certain people or for certain reasons, I should not dream of a medical career.

Medicine is about service. You are doing a disservice to half the population of this country by codifying an appalling belief: that women's LIVES are not as important as the FEELINGS of doctors who should never have gone into that practice in the first place.

And yes, this is about a woman's life versus the feelings of her doctor. If a woman cannot control her reproduction, she cannot control any aspect of her life. If a woman cannot delay pregnancy she is at a serious disadvantage compared to a man when it comes to getting an education, maintaining a career, and supporting herself. If at any time she could be railroaded into halting her life to bear a child at someone else's will, then her life as she know it can end at any time.

Anyone reading this, I'm begging you to think about this. Think about what effect having a child really has on women. In third world countries early pregnancy and single motherhood are one of the chief reasons that women and their children are economically and socially the biggest victims of poverty, disease, and hunger. Do you want that here? Are you ready for those consequences? Because that's where we're going.

If you love even a single woman in your life--mother, sister, daughter, friend, lover, anything--please protect her. Say no to this. Treat them like human beings, with wills and lives of their own. Let the women you love control their reproduction, instead of breeding on someone else's timeline and by someone else's rules. You owe them that much.

Comments

[e-mily.livejournal.com]

Particularly when the invisible hand of capitalism is guided not-so-subtley by the religious hand of the government.

1. If they don't want to offer a specific service, then they shouldn't have gone into (x) line of care.

2. It's not just a matter of a doctor saying "I don't offer that." They can be allowed to say "I won't offer that to you."

3. As virginia_fell has put it succintly multiple times.... There are many citizens who can't go somewhere else.


Also, I find it a highly crude simplification to compare healthcare to selling goods in a store.

[theglen.livejournal.com]

But again, forcing someone to do something they find abhorrent goes against everything this country is founded on. Doctors don't work for the government except in certain situations. Private care doctors shouldn't be told what to provide. If a doctor does not want to do abortions for whatever reason, it's not the government's job to say he has to. If someone finds abortion wrong for religious reasons, they cannot be made to violate their religion to provide it. Constitution is extremely clear on freedom of religion. Right to abortion however is not mentioned at all. So which right trumps which?

[praxian2007.livejournal.com]

There is also one other thing to recall. The doctors also take a Hippocratic Oath saying that they will put the care of the patient first and foremost.

http://en.wikipedia.org/wiki/Hippocratic_Oath

Now, if a patient needs an abortion for medical reasons, but your doctor doesn't believe in it, and carrying said child to term will have a high percentage chance of killing you...

Granted there would be easier chances of finding a doctor in that case who would say "Ok, the appointment is set." But if your primary care doctor says "No. I don't believe in those, lets do something different." you're screwed. Also, don't forget, that doctors CALL EACH OTHER for references. So if your primary care doc says no, then you have to go to Another doctor. And that doc office will likely call your primary care doctor if you tell them who s/he is. At which point the answer from most doctors will all be the same.

Why? Because doctors don't like stepping on other doctors toes.

So now what do you do?

In general, if you're going to take an oath to practice medicine, and do your best to help patients, then you need to take the good with the bad. Yes, abortions suck. I'm against them myself, but I am pro-choice. It's the womans body, it should be HER right, not mine, to do as she will. And there should be no doctor to tell her what she can and can't do with her own body either.

Also, don't forget, a doctor doesn't have to accept you as a patient.

As it pertains to which right trumps the other, in this case, the Hippocratic Oath would trump whatever moral religious obligation because living in America is indeed something where freedom of religion is practiced. However when you take that Hippocratic oath, you're saying that no matter what, you'll do what's in the best interest of the patient, even if that means doing something you don't like.

Patient Care > Moral Obligations.

I don't like it - but it's setup like it is for a reason. If a doctor doesn't like one part of the medical field, then there are TONS of other areas for him to go practice other than being a GP or a Gynecologist or any other doctor who has to deal with abortions. Interns have the option of where they intern at, they do not have to choose a spot where they'll run into that situation.

Imagine this as well: Someone that is against technology says "I don't use these items because it violates my religion.". Suddenly you go in for a surgery and there's no anastesia, there's no sleeping medicine, you don't get hooked up to anything to monitor your condition, and the doctor is standing there with a knife and a mid-wife for comforting.

This line of thinking with this rule will inevitably open the doors for doctors to "cut costs" and say something based on religion for not doing something to sacrifice patients health care because it's "cheaper" this way.

Just my way of looking at things.

[e-mily.livejournal.com]

Again, doctors currently don't have to provide abortions if they don't want to. It's not like most general practitioners provide them anyway.

Really, I'm not going to force a doctor to regularly provide abortions. But it would be nice if they would consider the health of the patient. Such as in the case praxian2007 describes, or perhaps a rape victim.

Then you start to weigh whether or not your morals have a higher value than the life/well being of the woman involved.

However, the possibility of them changing that definition so that they can refuse contraceptives to a woman is part of what's so screamingly not okay. And not just your doctor. Anyone at any part of the medical process could refuse you service or treatment.

Also, y'know, the whole Hippocratic Oath thing that praxian2007 mentions.

That's what keeps doctors from doing things like "accidentally" killing someone who they happen to dislike, for whatever reason. That's why doctors who actually stand by their oath DO treat prisoners of war.

[virginia-fell.livejournal.com]

Part of the problem is that A: Like many pro-life positions it places the priority on a potential life over an actual woman. This goes against medical precedent because medical practitioners are currently taught that this isn't good medicine. If a cancer treatment is going to save the mother but cause her to abort her child, the mother takes priority because she is a living human sitting right in front of you asking you for medical care. Doctors who don't believe in abortion could quite literally kill her in such a case because women are less important than the children they carry. Which is interesting, because it technically means that once a woman is born (or at least once she hits her childrearing years) she actually becomes less important than she was when she was an embryo. At least by the pro-life perspective.

The other problem is that B: The conscience of the doctor performing the procedure is upheld above the conscience of the patient. For example, I believe that with 500,000 or so children in foster care in this country it is morally irresponsible to have children. Call it the Bob Barker school of population moderation: spay and neuter yourselves. Adopt a kid who needs a home instead of making new ones. This is why I would have an abortion if I became pregnant: when I can support kids I feel a strong moral imperative to adopt instead of making babies of my own. However, DHHS believes my doctor should have veto power over this life choice. My doctor's conscience and judgment takes precedent not just on medical matters but on moral ones as well. This is why feminists get pissed about this. It treats women like they're not qualified to set their own timeline for breeding, instead being forced to do it on someone else's behest and by someone else's rules.

And before you say it, yes it is going to be someone else's rules, because if the woman agreed with her protesting doctor she wouldn't be there for an abortion. This means that doctors are enforcing an unshared moral imperative on a patient because she is not qualified to decide when she has kids: but her doctor is? It's like the ad campaign against pharmacists who refuse to fill certain prescriptions states, "I didn't choose to have children. My pharmacist chose for me."

You want to talk about freedom in America? How about the freedom to decide for yourself when to have children? I honestly think that women in this situation will suffer far more than doctors who face the trauma of meeting the same professional standards and providing all patients the same standard of care no matter what religion the doctor follows. The doctor has always had freedom of choice. It's called, "Do I want to go to med school, can I handle being a doctor?" If they went through med school, took their oath, and went into practice, they have already made their choice. I don't go to a steakhouse to be lectured by a Hindu about how eating beef is bad, and I don't go to bars to be served alcohol by a vocal prohibitionist. I don't go to a doctor to be lectured about how I don't deserve the medical care I came for, just because someone else's God cares about a single-celled parasite more than it cares for women.

[http://users.livejournal.com/_jeremiad/]

You know, 50 years ago, lots of doctors found it abhorrent to practice medicine on black people. Talking about doctor's rights to bar an entire portion of the population from medical care sounds as ridiculous now as it did then.

In another example...some religions find giving blood transfusions abhorrent. It just so happens blood transfusions save lives. If I was in a horrific car accident and the only ER physician on duty was one who didn't believe in blood transfusions, would he have the right to refuse to treat me and not to refer me to someone else knowing that I would die?

[arctangent.livejournal.com]

I just want to clear something up:

The law being debated is not whether the law will specifically define a set of obligations a doctor is required to fulfill that will be enforced by the government.

The law being debated is whether the government will *protect* a doctor from facing consequences from his employer, a private institution, for going against the guidelines they set out for him as a requirement of his employment.

That's why it's being phrased as "rights of conscience" being "protected" by the government, instead of the reverse, *removing* abortion from the "government-ordered responsibilities of a doctor".

It's not like that. The specific legislation being discussed is a law that would specifically make it illegal for a hospital to fire a doctor for refusing to practice certain medical procedures.

Under the law as it stands, that hospital is never *obligated* to fire said doctor, and hiring and firing are still decisions the administrators get to make based on their own beliefs, the professional standards among doctors within our culture, and yes, the free market.

So this law isn't *removing* an *obligation* to fire a doctor for not providing certain procedures. It is *putting in place* a *new regulation* that *prevents* a privately-owned hospital from choosing to fire a doctor because the private owners of that private hospital think that that doctor is a bad doctor for refusing to perform certain procedures.

There are a lot of arguments pro and con such regulations, but the whole "free market" argument really shouldn't be one of them, unless by that you mean the professional standards among doctors, *not* enforced externally by the government but set up by non-government organizations like the American Medical Association, hospital boards of directors, and medical schools somehow aren't part of the "private free market".

But, again, passing this law is not the government ceasing to force doctors to perform procedures -- it is the government *adding* a new regulation and *starting* to force private hospital administrators to keep doctors who they'd rather fire.

[arctangent.livejournal.com]

In other words, it's more like "If I work as a cashier at a store, and I refuse to serve a customer because I'm lazy or tired or don't like the look of him, I can be fired. However, the government has now put in place a law that says that if I can say I refuse to serve a customer because of a *matter of conscience*, my boss can't fire me, no matter how bad I make his store look or how much money I cost him thanks to my matter of conscience making it impossible to do the job he hired me to do."

This is the kind of thing conservatives tend to get really pissed about in other contexts, but to rally around and defend when it's in the interests of social conservatives. (Imagine how the mainstream evangelical community would react if we were talking about a Jehovah's Witness doctor's right to refuse to perform blood transfusions, or an atheist doctor's right to refuse to perform fertility procedures for Quiverfull Christian parents.)