Opting Out of Providing Care.

Despite the fact that most Americans might hope that Bush lays low in the final days of his historically unpopular presidency, he’s decided to try to push through at least one last-minute agenda: a plan that would allow health care providers to refuse to perform abortions and other procedures they object to on moral or religious grounds.

The proposed rule would prohibit recipients of federal money from discriminating against doctors, nurses and other health care workers who refuse to perform or to assist in the performance of abortions or sterilization procedures because of their “religious beliefs or moral convictions.”

It would also prevent hospitals, clinics, doctors’ offices and drugstores from requiring employees with religious or moral objections to “assist in the performance of any part of a health service program or research activity” financed by the Department of Health and Human Services.

But three officials from the Equal Employment Opportunity Commission, including its legal counsel, whom President Bush appointed, said the proposal would overturn 40 years of civil rights law prohibiting job discrimination based on religion.

The counsel, Reed L. Russell, and two Democratic members of the commission, Stuart J. Ishimaru and Christine M. Griffin, also said that the rule was unnecessary for the protection of employees and potentially confusing to employers.

Title VII of the Civil Rights Act of 1964 already prohibits employment discrimination based on religion, Mr. Russell said, and the courts have defined “religion” broadly to include “moral or ethical beliefs as to what is right and wrong, which are sincerely held with the strength of traditional religious views.”

It’s not that anyone wants to force doctors who object to abortions to perform them. They already don’t have to. That’s the point. This is unnecessary and confusing.

But the bigger problem is that it puts something that doesn’t belong between a doctor and his duty to care for a patient to the best of his or her ability. If a woman wants birth control, she should be able to go to her doctor and get it. If a pregnancy endangers her life, she should trust that a doctor would counsel her on abortion. If a patient needed a drug that had been tested on animals to regulate their blood pressure, a doctor who was also a member of PETA wouldn’t be able to refuse to prescribe it.

But all of this goes back to some wonky religious ideas that have nothing to do with religion. It’s part of what I’ve decided is the overall problem with Christianity as its practiced by some in this country. Other religions, like Buddhism and Hinduism, celebrate gods or forces that are both creative and destructive. Destruction clears the way for creativity. As was once put to me by the son of a Pentecostal preacher (whose religion required him to wear pants through unbearable Arkansas summers but did not prevent him from reaching the logical conclusion that evolution was the most likely explanation for how life on earth had changed over time), the existence of good depends upon evil, or it ceased to have any quality at all. Christianity cast out the destructive force when it sent the devil to hell.

The religious right only believe God exists when they decide a life is created. So God enabled doctors to be able to fertilize eggs in a test tube for couples who otherwise couldn’t have children, but he doesn’t allow them to use those cells to save lives that already exist. Likewise, a woman who might die in childbirth can’t abort the baby, though doing so would help perpetuate the human race even more than the risky pregnancy because she could survive and reproduce in the future instead. And God didn’t enable us to regulate our own reproductive lives, thereby giving our offspring a better chance.

Tagged: , ,

14 thoughts on “Opting Out of Providing Care.

  1. Ralph H. Manningfield November 19, 2008 at 5:06 am Reply

    Wow. This has been an interesting decade.

  2. simply scott November 19, 2008 at 8:14 am Reply

    honestly i understand the “religious” less and less, which is why more and more i just stay away. i tend to think religion is mostly based on fear — fear of dying and what comes after, and politics — pushing a personal agenda and trying to make others do what you want them to do or behave in ways you want them to behave.

    Bush has demonstrated that he has many flaws, but these last few acts of his, whether it be this ridiculous attempt to control people through medicine or his feverous work to push through thousands of last-minute pro-business regulations, show him to be manipulative and completely cut off from the notion that he was elected to serve ALL of the people, not just the ones who pay his bills (campaign contributions).

    finally, this is just another reason to push out Washington lobbyists and reform campaign finance. the government needs to be “by the people” and “for the people” again (and the best way to do that is push power back to the states — see Ron Paul).

  3. Rahsaan November 19, 2008 at 10:03 am Reply

    You know, this goes back to my firm belief that many to the far conservative right have a great deal of concern for lives while they’re en utero, but capriciously ignore the repercussions that may affect the child produced by an unwanted pregnancy.

    Taking a worst case scenario, like brutal rape… in the perfect world of many conservatives (many; not saying all or even most), a woman would be forced to carry to term. What if said woman hated this child and all it represented to her during its gestation? Scientists still aren’t quite sure how the impact of negative emotions acts upon a developing fetus. (Not to mention possible deliberate malnutrition on the mother’s part.)

    All for this child of rape to possibly come into the world with such negative emotions surrounding it from the jump? Is that a fair shot at life? Many to the right would say life is life, and discount the hardships this child may be forced to weather due to the circumstances of its conception.

    Not to say, such a child can’t go on to live a happy life. However, the alternative should be considered. Simply put, abortion is not always only in the best welfare of the parents, but sometimes quite possibly the child. The irony of many pro-lifers seems to be that passionate attempt to preserve life and its quality don’t extend much beyond the first nine months post-conception.

  4. ladyfresshh November 19, 2008 at 11:10 am Reply

    frankly scott i don’t trust the people. the people voted for prop 8.

    Gov’t does need to be swung back in the direction of confirming civil liberties and a firm seperation of church and state. The line has been blurred and it needs to be clarified for those who do not understand that religious and personal regulations should not and cannot be federal mandates.

    this is ridiculous

  5. glory November 19, 2008 at 11:22 am Reply

    ditto to ladyfresshh’s comment – sometimes i don’t trust the people. if it was left up to the people, i would have been denied admission to my graduate school and i’d probably be cleaning some lady’s house, working as a secretary, or teaching in a substandard school. sometimes it’s the federal government who can make things right when the states get it wrong. she’s spot on about civil liberties, as well.

  6. kaya November 19, 2008 at 7:55 pm Reply

    as a doctor who is very strongly pro choice, i still have mixed feelings about this one. in fact, i didn’t know that healthcare employees could be required to participate in procedures that they find morally wrong. in all of my medical training, i have always benn told the same thing – if you have objections to doing something, you have a right to refuse to do it. but you have the obligation to refer the patient to someone who will. this applies everywhere from prescribing birth control pills to performing circumcisions or 2nd trimester abortions.
    i think the legislation is unecessary and sensationalistic. but i DO agree that no doctor/nurse/whatever should feel obligated to do any elective procedure that they have moral objections to.
    this becomes difficult in underserved areas, where there may be one doctor for hundreds of miles…what happens when this person becomes the local medical moral authority? don’t ask me how to fix that one.

  7. Mary Anne Mohanraj November 20, 2008 at 7:58 am Reply

    Kaya, that was the crux of the dilemma in the book/movie Cider House Rules — in a time when abortion was illegal, a pro-life doctor was faced with the choice between performing safe abortions, or ‘keeping his own hands clean’ and accepting that women would turn to dangerous alternative abortions instead. Despite being strongly pro-life, he made the decision to perform the abortions for as long as these women had no other safe, legal options.

    He felt that the decision whether to abort was theirs, not his, and that if they chose to, his duty as a doctor required him to help them do it as safely as possible. That’s a difficult moral choice for anyone, of course, but given the Hippocratic Oath, I think that’s one a lot of doctors would make. Once you’ve seen desperate teenagers get sepsis and die from back-alley coat hanger abortions, I suspect that clarifies your stance on the matter for you.

    Excellent book, well worth a read for anyone interested in this issue, even though I just gave away a lot of the plot. Subtle, complex handling of a difficult issue.

    (My father and two sisters are doctors, but I am not.)

  8. shani-o November 20, 2008 at 10:06 am Reply

    this becomes difficult in underserved areas, where there may be one doctor for hundreds of miles…what happens when this person becomes the local medical moral authority? don’t ask me how to fix that one.

    That’s what bothers me, too. What about the women in Montana or wherever who have to go a 100 miles before they can find a doctor who is willing to counsel them on their reproductive options? That’s very scary to me. I don’t believe in forcing a doctor to do something, but legislating this just seems like a way of denying women care.

  9. kaya November 20, 2008 at 6:44 pm Reply

    good points, mary ann and shani-o. sorry for the LONG responses…

    “He felt that the decision whether to abort was theirs, not his, and that if they chose to, his duty as a doctor required him to help them do it as safely as possible. That’s a difficult moral choice for anyone, of course, but given the Hippocratic Oath, I think that’s one a lot of doctors would make.”

    interestingly enough, the original hippocratic oath included a promise to NOT perform abortions. which points to just how variable the opinions of exactly what is the kind of care a responsible, moral physician should provide. (or, of course, the sexism that continues to exist in medicine)

    “Once you’ve seen desperate teenagers get sepsis and die from back-alley coat hanger abortions, I suspect that clarifies your stance on the matter for you.”

    for me, perhaps. but there is the school of thought that though those situations may be tragic, it still doesn’t mean that it is your obligation to provide safe abortions. i think it’s really easy for people who haven’t actually seen/performed an abortion to say what doctors should/shouldn’t do (i sure did, before medical school). as someone who is pro-choice, when it came time for me to actually do abortions, i still had moral issues with it. have you ever had to count up the tiny arms and legs of a newly aborted fetus to make sure you got everything out? or cut off a head or cut up a fetus’ body parts so that it could fit out of a woman’s cervix? (sorry!) i can’t imagine the effect that would have on someone who was already strongly opposed to this in the first place. people have these ideas that doctors are supposed to be so technical and professional, and above these emotions, but we are still human. even if she is the one making the decision, you are the vessel which is allowing it to happen. and depending on your beliefs, this in itself can be very traumatic. and i would NEVER want to force that upon anyone.

    “Excellent book, well worth a read for anyone interested in this issue, even though I just gave away a lot of the plot. Subtle, complex handling of a difficult issue.”

    saw the movie, never read the book. how could i resist michael caine AND heavy d 🙂 !?!

  10. kaya November 20, 2008 at 6:46 pm Reply

    “What about the women in Montana or wherever who have to go a 100 miles before they can find a doctor who is willing to counsel them on their reproductive options? That’s very scary to me. I don’t believe in forcing a doctor to do something, but legislating this just seems like a way of denying women care.”

    i’m inclined to agree. but could you imagine how awful it would be getting an abortion from a doctor who thought it was wrong but was forced to do it? jesus.

  11. quadmoniker November 20, 2008 at 8:55 pm Reply

    I’m pretty sure no one could have forced a doctor to perform a procedure in the first place. That’s the biggest problem here, it makes an issue out of a non-issue. No one can force a doctor to do anything, and no one can fire him or her because of their religious beliefs. And this may sound crass, but I don’t think we should have a rule that says the doctors feelings are more important than the patient’s care. People in other professions have to put their feelings, opinions and beliefs aside all the time as well.

  12. kaya November 20, 2008 at 9:23 pm Reply

    quad i understand what you’re saying but doctors’ feelings often have a role in patient care. as in, if a doctor feels that a patient shouldn’t have an elective procedure, they have a right not to do it. yes, this is different in life-saving procedures, but for all elective procedures, this is pretty much the rule. but you’re right, the law pretty much serves to make an issue out of a non-issue. i’m just playing devil’s advocate here. it’s kind of a pet peeve of mine when people place all these hifalutin expectations on physicians and don’t realize that we are people too!

  13. quadmoniker November 20, 2008 at 10:35 pm Reply

    I understand what you’re saying, but the fact that doctors are human is why I don’t like this rule. I don’t expect my doctors to be superhuman and always know what’s best for me, which is why I expect to have some control over my health care. With other elective procedures, is it the doctors’ “feelings,” or is it their best judgement of a situation based on the facts of the case and what they know of that person’s health? I suspect the latter. The courts have decided time and again, for the most part, that a women is best suited to decide whether she should have a baby. A doctor can opt out of performing an abortion if he or she wants, but a woman who wants an abortion should reasonably be able to have one performed.

  14. Clinton Weighs In « PostBourgie November 24, 2008 at 2:16 pm Reply

    […] Salon has a response from Hillary Clinton and Patty Murray to the new Bush rule that states doctors have a right to opt out of procedures (from abortions to prescribing birth control) they object to on religious or moral grounds. Note: […]

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: