Obama Administration Rescinds Bush Era Conscience Protection

"The Obama administration on Friday rescinded most of a 2008 rule that granted sweeping protections to health care providers who opposed abortion, sterilization and other medical procedures on religious or moral grounds. Kathleen Sebelius, the secretary of health and human services, said the rule, issued in the last days of the Bush administration, could 'negatively impact patient access to contraception and certain other medical services.'"

These are the words of the NY Times article detailing the Obama administration's latest action concerning the Bush Era conscience protection measures that finally gave teeth to the Church and Weldon amendments that specifically protected health care workers from being forced to assist or perform abortions.  Previoulsy the commentary on the HHS regulations had read:

The ability of patients to access health-care services, including abortion and reproductive health services, is long established and is not changed in this rule. Instead, this rule implements federal laws protecting healthcare workers and institutions from being compelled to participate in, or from being discriminated against for refusal to participate in, health services or research activities that may violate their consciences, including abortion and sterilization, by entities that receive certain funding from the department. (It also implements the provisions of federal law which protect health-care personnel from being discriminated against for their participation in any lawful health service or research activity, including abortion and sterilization, by entities that receive certain funding from the department.)

This is quite contrary to the tune that Kathleen Sebelius, the current director of HHS is singing.  The new rule will maintain an office for complaints to be filed, but given that the Obama administration has effectively ignored the the Bush Rule that was in place for the past 2 years, it is doubtful that this office will do much of anything when a nurse, student, or physician is pressured by an employer or school to assist or perform in an abortion.  The Vanderbilt Case is a good example.  More and more pressure is being applied to health care providers to simple 'go with the flow' and do whatever the patient desires in regard to abortion and contraception.  We are losing our rights, and in losing our rights, the patient is losing theirs.

In 2009 I wrote a paper for the Linacre Quarterly entitled The Loss of a Physician's Freedom of Consicence will Result in the Breakdown of Patient Autonomy within the Doctor-Patient Relationship.  In this article I wrote:

The doctor-patient relationship is founded upontrust. The patient must trust the doctor to keep confidentiality, to respect his autonomy, and to do the patient good. The doctor must trust that the patient is telling him the complete information and will follow the treatment plan. Without trust, effective health care is not going to occur. How does the conscience fit in with trust? Take, for example, an individual who is a Jehovah’s Witness. The patient is in a situation where the doctor is recommending a blood transfusion, but the doctor also knows that this individual will not take a blood transfusion because it would be a violation of their conscience. The patient must trust the doctor to respect their conscience and thus their autonomy. If the patient does not feel that a doctor would respect their autonomy, then an effective relationship will not be established and the patient will be in fear of what the doctor may do. However, one key way that a patient can know that a doctor will respect their conscience and autonomy is by seeing that the doctor respects and adheres to his own conscience. How could a patient trust a doctor to respect his own wishes if the doctor is willing to violate that very faculty that is supposed to help him recognize truth and act according to it? It would seem that most patients may have a difficult time fully trusting this doctor to act in their best interest. To brush these concerns aside is to ignore a reality of human nature and to put at risk the foundation of the principle of autonomy in medicine.

This step of the Obama Administration is another attack on not only health care providers, but also on patients themselves.  The continuing erosion of the rights of the provider will only continue until the rights of the patient to make medical decisions for themselves has been eliminated as well.  We must continue to fight for our right to practice medicine as our faith and our conscience directs us, it is the only way that the true Art of Medicine will be saved.

Conscience Rights Revisited In Washington State

Some possible good news coming out of Washington state. For the past several years there has been quite a fight over the dispensing of Plan B by pharmacies in that state.  A couple of pharmacists stated they would refuse to dispense it because it causes abortions, and so the state turned around and forced them to dispense it upon penalty of losing their license.  However, now there is a chance that pharmacists will maintain some of their freedom of conscience, though not based upon the ruling of the Federal Appeals court.  The Board of Pharmacy wants to revisit their regulation requiring all legal prescriptions to be filled.  The proposed change would only require a 'referral' by the pharmacist to another pharmacist who will accommodate.  Now, anyone with any basic understanding of moral theology knows that referring is still too proximal to the moral act to be justified.  If a pharmacist cannot dispense, then they cannot refer, because they are still aiding the person in the completion of the action, ie abortion. 

The Story:

Pharmacy board takes another run at Plan B rule

THE NEWS TRIBUNE

Published: 07/15/1012:05 am

The state Board of Pharmacy and pharmacists suing it over Plan B want out of court.

The litigants asked federal district court Judge Ronald Leighton last week to put their legal fight on hold pending the resolution of a new rule-making process.
The move angered advocates of unfettered access to Plan B emergency contraception. They contend the delay signals an undoing of a 2007 victory: the passage of rules requiring pharmacists to dispense a drug unless another pharmacist is available in person or by phone to step in.
The pharmacy board voted last month to reopen the rule-making process to consider “facilitated referral,” which is essentially the “refuse and refer” rule that the board embraced in 2006.
Under that rule, pharmacists with moral objections to Plan B – some consider it tantamount to abortion because it prevents implantation of a fertilized egg – could refuse to dispense it as long as they took steps to help patients get it elsewhere.
Back then, the proposal prompted Gov. Chris Gregoire to threaten to remove any pharmacy board members who voted for it. Her spokesman recently said she plans to make her opinion known to the board once again.
Pharmacy board members – most of whom have joined since 2007 – may indeed be headed for an about-face, but it’s too soon to assume that’s where they’ll end up.
Certainly, the goal is to write a rule that answers the concerns of the two pharmacists and Olympia grocer who are suing the state.
State lawyers hope to head off several more years of litigation – and a possible constitutional finding. The plaintiffs say that the state’s rule violates a pharmacists’ religious freedom. It is not a negligible argument, even if the often reversed 9th Circuit Court of Appeals last year ordered Leighton to apply a standard more deferential to the government.
But any proposed rule will still have to be vetted by an extensive public process – a process likely to raise the same concerns as were voiced in 2006 and 2007.
The pharmacy board will have to again wrestle with situations in which a pharmacy’s refusal to dispense Plan B effectively blocks a patient from receiving the drug.
The pill should be taken within 72 hours – preferably 24 hours – to be effective at preventing pregnancy. Under “facilitated referral,” a patient in the hinterlands might have to travel some distance to find a pharmacy willing to stock Plan B.
Pharmacy board members probably haven’t spared themselves any grief by trading a legal battle for a public policy fight. They have more than a court case to settle; they also have to convince a lot of concerned people that any new rule protects access.

Read more: http://www.thenewstribune.com/2010/07/15/1264410/pharmacy-board-takes-another-run.html#ixzz0uDzP4vS3

Here is something else to consider.  Washington state has legalized assisted suicide.  Now, some pharmacists don't have too much of a problem with Plan B, but what about the drugs used for suicide?  Will the state force more pharmacists to fill these drugs or make them refer?  And if the state is willing to do this to pharmacists, then how long will it be before physicians are forced, as a condition of their license, to perform abortions and assist in suicides?

For more, see Wesley J. Smith's commentary.