Americans Support Conscience Protection: Is Anybody in Washington Listening?

Submitted by Randy Pate on Thu, 04/09/2009 - 09:14

New polling data released yesterday shows the majority of the American public supports a Bush Administration regulation protecting the conscience rights of health care providers, including doctors and nurses, who object to participating in controversial procedures such as abortion and sterilization.

The poll found overwhelming support for a patient’s right to seek care from a doctor who agrees with them on sensitive moral issues surrounding their health. But the apparent divide between Washington and the American people on this important issue couldn’t be greater. The Obama Administration wants to rescind federal regulations known as "conscience protections." Today is the final day to register a comment (click here to leave yours).

The poll, which surveyed 800 American adults of both political parties and independents (39% Democrats, 33% Republican, and 22% Independent), found 87% of Americans believe it is important to “make sure that health care professionals are not forced to participate in procedures and practices to which they have moral objections.” The results held true across the ideological and partisan lines, as 78% of Americans describing themselves as “pro-choice” supported health care provider conscience protections.

While the United States has a long tradition of protecting individual conscience rights stretching from the First Amendment to laws protecting conscientious objectors in time of war, Americans’ views on health care provider conscience rights are as much rooted in self-interest as they are in altruism towards doctors: 88% of Americans surveyed said it is important to them that they hold a similar set of morals as their doctors, nurses, and other health care providers.

Without strong protection of conscience rights for health care providers, Americans know their health care—both in access to and quality of care—will suffer, as faith-based doctors and other professionals leave the profession rather than be forced to violate their conscience.

Thorny issues of morality and ethics abound in health care, ranging from the beginning of life (abortion, in vitro fertilization, etc) to the end of life (physician-assisted suicide, advance directives, etc). Patients have a right to see a doctor of their choosing, without fear of government intrusion into the doctor-patient relationship. Patients and their families have the right to have tough conversations about, for example, life support for themselves or their loved one, with a medical professional that shares their beliefs surrounding end-of-life care. The farther government intrudes in these deeply personal issues by compelling doctors to violate their conscience, the more budgets and balance sheets will replace compassion and caring.

Failure to protect conscience rights for health care providers will have a direct, negative effect on patients’ ability to get the care they need. For example, Catholic hospitals alone make up about 20% of all hospitals in the country and serve over 5.5 million patients a year. If these institutions’ conscience rights are not protected, they could be forced to shut their doors or reduce services. Undoubtedly, poor and rural patients served by these institutions will suffer the most in such a scenario.

In spite of this, the Obama Administration and Congress seem intent on rolling back conscience protections in health care. After less than two months in office, the Obama Administration proposed to eliminate the conscience protection regulation. Last Friday, the Senate rejected an amendment that would have included conscience protections in President Obama’s $634 billion “down payment” for health care reform. The amendment, offered by Senator Tom Coburn, himself a doctor, would have prohibited government coercion of patients to enroll in specific health insurance plans or to see pre-selected health care providers. Given the chance, the Senate said “no” to giving patients freedom to choose a doctor that shares their beliefs on important moral and ethical issues.

While the American people strongly support conscience rights and freedom of choice in health care, Congress and the Obama Administration are moving rapidly in the opposite direction: toward increased government intrusion into Americans’ most private and personal health care decisions.

The public has until midnight tonight to let the Department of Health and Human Services know its support of conscience rights in the health care work place. Visit ADoctorsRight.com to register your comment with HHS today.

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Given the way the poll questions are worded

Submitted by NextRightNando on Thu, 04/09/2009 - 09:51.

Given the way the poll questions are worded, they must be disappointed they didn't get 100% support.

I could commission a poll asking questions like "do you agree that it is wrong for the only doctor/pharmacist in town to refuse to issue/fill a prescription for contraceptives/Viagra for an unmarried patient becasue the doctor/pharmacist believes that sex outside of marriage is immoral?" I'm pretty sure I'd get very high agreement, too.

As someone

Submitted by Progressive Tra... on Fri, 04/10/2009 - 04:44.

... that used to drive 45 minutes to pick up my mail, I can assure you that people in those rural and small town areas understand that they might not have everything right at their fingertips, regardless of the shock value that might be revealed among ignorant city folk.

And so that makes it OK for the person to have to drive 90 miles

Submitted by NextRightNando on Fri, 04/10/2009 - 09:21.

And so that makes it OK for the person to have to drive 90 miles to get to the next pharmacy in order to get a legal prescription filled? And if that pharmacist also happens to be a member of the American Taliban, they can go on for another 45 miles, hoping for the best?

you know, some of us city dwellers have had the good

Submitted by RisingTide on Fri, 04/10/2009 - 09:55.

fortune to live on a family farm. ;-)

I know of a few people thinking of retiring down to one of those small towns... the wife doesn't drive. I think about that, not just the mobile folks with cars. And I think about the girl who doesn't want to tell her parents that she was raped (should she have to?), just to swing a ride to the nearest pharmacy.

A few different issues there

Submitted by Progressive Tra... on Sat, 04/11/2009 - 05:17.

One is that parents have a legal right over their children. They are liable. I see no reason that they should be denied such information. I believe the standard for the state coming into the parent-child relationship is fairly high.

Secondly, any contract with a minor is voidable at the will of the minor. That is, any transaction which the minor might undertake is voidable at will. That tells me that it's a pretty risky business to be involving oneself in such transactions in the first place.

Third, people in those places didn't just drop out of the sky. They know people, who also know people. Word gets around.

In the example above, driving 90 miles to get to anywhere without first calling ahead makes one an idiot. Who on earth would drive an hour and a half for a maybe, without confirmation? They do have the telephone out there, you know.

Here is a simpler solution.

Submitted by NextRightNando on Sat, 04/11/2009 - 15:14.

Here is a simpler solution. The pharmacist does his job - he fills legal prescriptions. Refusal to do so results in loss of the quasi-monopoly the government gives him.

If he wants to be a preacher, he can change jobs.

Shall we start letting soldiers exercise their conscience re shooting people? Let the guy at the DMV refuse to issue license plates to Hummers because they are destroying the planet?

Your point is a good one, but

Submitted by iwall on Sat, 04/11/2009 - 15:44.

Your point is a good one, but just so you know, US military personnel *can* exercise their conscience when it comes to shooting people. We have a conscientious objector program designed to keep religious and moral objectors from combat situations. It is stigmatized by the officers and very seldom-used, but it does exist.

But they aren't allowed to go about their everyday duties

Submitted by NextRightNando on Sat, 04/11/2009 - 17:02.

But they aren't allowed to go about their everyday duties and then every once in a while say "Sir, no, I don't want do that, ever so sorry but it really is wrong, you know."

Like your Hummer analogy!

Submitted by acinphx on Sat, 04/11/2009 - 20:36.

Now, that's a conscientious objection I could really get behind! It may be a stronger example than the military analogy because it is easy for someone to come back with the conscientious objector response. Though as someone else pointed out, military personnel don't get to pick and choose whom they will engage in combat against, e.g., "I have no objection to shooting Taliban, but not gonna do it to Iraqis" -- it's an all-or-nothing proposition, unlike the pharmacist who would be allowed to substitute his/her conscience for the patient's in choosing which prescriptions to fill (or not).

And I'm really not getting the problem with doctors supposedly being expected to perform abortions against their conscience -- why the heck would any sane person become an abortionist if they object to it? I must be missing something because it's so patently nonsensical. I guess I need someone to explain to me how it is that someone could wind up an unwilling or accidental abortionist?

the Hummer analogy

Submitted by Ray in TX on Sun, 04/12/2009 - 11:03.

is spot on, although I would change it to a gas station operator. Any conservationist (liberal or conservative) can use that to effect against this "free conscience" talking point.

At issue is whether someone can arbitrarily invoke personal morals as a pretext to withhold services in the public marketplace. I would argue that they CAN, provided that those objections are stated publicly for potential customers.

For example, if the evangelical pharmacist posts a notice stating "we choose to withhold contraceptive services to unmarried customers on personal moral grounds", then they should be free to have that policy.

However, they generally wouldn't want to do that because they would lose a lot of business to customers who object to that policy. Therefore, they keep this policy private so that they can selectively use it.

you haven't lived around dominionists much...

Submitted by RisingTide on Mon, 04/13/2009 - 12:30.

they would GAIN business, not lose it. That's what shtetls are like.

I live in TX

Submitted by Ray in TX on Mon, 04/13/2009 - 12:43.

I am very familiar with Dominionists and their Bible-worshipping flocks. Two of my cousins would probably be categorized as such. They're not as prevalent as you think; they're just very vocal. A "Christian-only" business would wither on the vine if it alienated the secular customer base.

Also, thank you for giving me a new word!

I gotta say, it's not texas that I worry about...

Submitted by RisingTide on Tue, 04/14/2009 - 09:21.

It's places like Wyoming and Colorado Springs, and the Dakotas -- places where they really could set up a completely separate society (like the Mormons have done, for all extents and purposes in Utah).

On my side of the fence (Jewish), we still have functioning Orthodox shtetls in New York State, that shamelessly steal from the public teat.

As you might could tell, I don't like ANYONE who wishes to subvert the free market by the use of religious (or racial) tests. My grandparents and greatgrandparents were shopkeepers -- these are the folks who could ruin a small business. [I'm not against all 'fair market' principles... e.g. it's perfectly fine for someone to say "I'm only giving my business to companies that help my neighborhood" -- that at least gives all companies a fair shot at getting your business]

each person has the right to privacy.

Submitted by RisingTide on Mon, 04/13/2009 - 12:31.

I'd rather see a better definition of what makes a minor, personally -- once someone is capable of making contracts, they shouldn't be a minor anymore.

someday...

what makes a minor

Submitted by Ray in TX on Mon, 04/13/2009 - 12:53.

If you want to commit a crime, you are an adult around 16, varying by state and crime.

If you want to have sex, you are an adult around 15-17, depending on the state in which you choose to have sex. But if you get pregant, you generally can't make an adult decision about terminating it until you are 18.

If you want to vote or join the military, you are an adult at 18.

If you want to have a beer, you are not an adult until 21.

I hope I've cleared that up for you.

Soooo

Submitted by Jim Dandy to th... on Thu, 04/09/2009 - 10:10.

.. this was a poll run by Kellyanne Conway? GOP strategist and consultant Conway? FOX News Conway? American Solutions Conway? Worst-person-in the-World Conway?

I think I would need her poll results confirmed by a more neutral polling company before I started making decisions based on those results.

You want to take federal money for your hospital? Then you have to abide by Federal rules. Private hospitals and private organizations, of course, are free to treat whoever and however they want. The free market is their boss. You want to practice medicine your way? Fine, excellent. Work for a private healthcare firm who allows that, and leave your federal-money job.

And please don't tell me "Patients have a right to see a doctor of their choosing, without fear of government intrusion into the doctor-patient relationship. Patients and their families have the right to have tough conversations about, for example, life support for themselves or their loved one, with a medical professional that shares their beliefs surrounding end-of-life care."

Where does it say that the Federal Government has to pay for that? If they so desire, if that is important to them,. let them go to a private Hospital where they can get the kind of care they think they want or make other arrangements. Federal employees are bound to obey Federal laws, including Roe v Wade. Period.

I would love to see these people trying to argue the merits of a hospital bill from an out-of-network private Christian facility with an Insurance Adjuster from United Healthcare or Empire Blue Cross. Care to guess how much they would cover?

Since you brought up federal law...

Submitted by Randy Pate on Thu, 04/09/2009 - 13:39.

Jim Dandy,

I'm glad you brought up federal law. Actually, three separate federal laws enacted over the last 35 years prohibit institutions receiving federal funds from the Department of Health and Human Services, including programs like Medicare and Medicaid, from discriminating against doctors, nurses, and hospitals that object to performing controversial procedures such as abortion and sterilization.

So, in fact federal law says the opposite of what you assert: if you accept federal funding, you cannot discriminate against health care providers on the basis of their objection to abortion. Regardless of the outcome of the Obama Administration's effort to rescind the health care conscience protection regulation, these laws will still be on the books. It's the job of the Chief Executive to enforce the law, even those with which he may disagree.

And where in federal law does it say patients have a right to see a doctor of their choosing, who agrees with them on sensitive moral issues? It doesn't. Yet. That's why Senator Coburn introduced an amendment in Congress that would protect patients from government coersion in selecting a health plan or a doctor. And judging by the efforts of the Obama Administration to vastly expand the role of government in health care, such protections are needed now more than ever.

Thanks for your comment.

Last Minute Bush Rules

Submitted by ToddLuvsLounging on Thu, 04/09/2009 - 14:54.

Liberal ToddLuvsLounging Says:

This was one of those last minute Bush rules the late administration tried to jam through at the end of 2008. There are several laws already on the books preventing coersion from happening. Nobody is going to force a doctor or a nurse from performing procedures they are morally against. But this ruling is a backdoor attempt to restrict contraceptives by allowing pharmacists to opt out or to prevent rape victims to having access to emergency contraceptives or void state laws requiring insurance companies to cover contraceptives.

Let's Get the Facts Straight

Submitted by Randy Pate on Thu, 04/09/2009 - 16:27.

Todd,

Far from being a "last minute" Bush regulation, the health care conscience protection regulation was developed in part to respond to a November 2007 ethics opinion by the American College of Obstetricians and Gynecologists stating that physicians and other health care professionals had an obligation to refer for abortions, even if it violated their conscience. This ethics opinion raised concern that OB-GYNs might lose their board certification if they did not refer for abortions in spite of their moral or ethical objections. So work on the regulation began at least a full year before the end of the last administration, hardly the eleventh hour.

And yes, there are already 3 federal laws on the books prohibiting recipients of certain HHS funds from discriminating against health care providers who object to performing abortions. However, in over 35 years of these laws' existence, no federal regulation had been issued to enforce the law (e.g., no component within HHS had been designated to receive or investigate allegations of discrimination, etc).

Regulations implement laws passed by Congress. For example, Congress passed the Food Drug and Cosmetic Act to ensure the safety of food and drugs. But by your reasoning, the FDA, which promulgates regulations implementing food and drug safety laws, shouldn't issue regulations for food safety because there are "laws aleady on the books" to ensure safety. Laws don't mean much if they aren't enforced. The health care conscience protection regulation is necessary because it provides for the implementation of existing law, something that is much needed to protect the conscience rights of health care workers.

Thanks for the comment.

More Facts

Submitted by ToddLuvsLounging on Thu, 04/09/2009 - 19:44.

Releasing a controversal ruling in the next to the last month of an administration against the view of the largest OBGYN professional association qualifies as 'last minute' in my opinion. Why not recommend further investigation or require other procedures for transmitting reproductive information for such a sensitive issue instead of an overly broad, poorly interpreted regulation. Here is the response to Sec. Leavitt before the new regulation and after the new regulation is in place. The American College of Obstetricians and Gynecologists (ACOG) vehemently denies anybody would have lost their board certification. ACOG also brings up pertinent patients' rights issues to know about abortion, were they ever answered? Why was Sec Leavitt in such a rush to approve the new regulation over the objection of ACOG? In my opinion, this a political ruling done in haste to reward an important segment in the Republican party rather than a professional, considered regulation to safeguard personal conscience or patient's rights.

I doubt there is a need for new regulation and if this poor regulation had been implemented than patients would have suffered more from health professionals withholding medical information from their patients. Does every law and ruling require new regulation and enforcement mechanism? Is this such a huge problem in the medical field that government has to step in more forcefully? The ACOG believes medical professionals have more than enough protection.

sometimes you don't need an investigating body...

Submitted by RisingTide on Fri, 04/10/2009 - 09:59.

when you don't set rules that make discrimination legalized, often it doesn't happen (look at FHA loans for the counterpoint)

So now, we aren't on about "forcing someone to perform a procedure" == we're on about "give the girl a way that she can make her own choices" instead of paternalistically making the choice for her.

Did I mention how much I fucking hate paternalism?

If what's required is hiring one person in your office who will refer to a abortion-giving gyn... is that so bad?

Conscience Rules

Submitted by Jim Dandy to th... on Thu, 04/09/2009 - 16:02.

The "rules" in USC date back to the Church Amendments from two generations ago. Further, one of the rules is an appropriations rider, and the other is a last-minute Bush Executive Order.

Here is what the Doctors themselves say, according to the HHS:

http://www.hhs.gov/news/press/2008pres/03/20080314a.html

"...the American Board of Obstetrics and Gynecology’s (ABOG) Bulletin for 2008 Maintenance of Certification (Bulletin) with a recent report (Opinion Number 385) issued by the American College of Obstetricians and Gynecologists (ACOG) Ethics Committee on November 7, 2007 entitled “The Limits of Conscience Refusal in Reproductive Medicine”.

The ACOG Ethics Committee report recommends that in the context of providing abortions, “Physicians and other health care professionals have the duty to refer patients in a timely manner to other providers if they do not feel that they can in conscience provide the standard reproductive service that patients request.”

You are saying something entirely different here: That the medical professionals involved should have no responsibility other than to their own moral judgments, and further that these can neither be questioned nor regulated.

I understand you and the Heritage Foundation you work for have a vested interest in helping the Christian Right further their goals. That last-minute Bush executive order was intended to strengthen the hand of those who want to throw a wrench into medical organizations that provide birth control and abortions, and to help those organizations who do NOT still qualify for Federal money. Further, exaclty what constitutes "discrimination"? The Bush order sets penalties and allows considerable latitude in the use of that word.

http://www.cbsnews.com/stories/2009/02/28/health/main4835158.shtml?sourc...

"...Federal law has long forbidden discrimination against health care professionals who refuse to perform abortions or provide referrals for them on religious or moral grounds. The Obama administration supports those laws, said the HHS official.

The Bush administration's rule adds a requirement that institutions that get federal money certify their compliance with laws protecting the rights of moral objectors. It was intended to block the flow of federal funds to hospitals and other institutions that ignore those rights.

But the Obama administration was concerned that the Bush regulation could also be used to refuse birth control, family planning services and counseling for vaccines and transfusions.

"The administration supports a tightly written conscience clause," said the HHS official. "While we are concerned about the Bush rule, we also understand there might be a need to clarify existing laws..."

I am glad the Obama Administration is rethinking this, it is yet another avenue for those on the Right who wish to impose their morals on the rest of us.

providing birth control

Submitted by lgm on Fri, 04/10/2009 - 06:50.

How about asking whether a pharmicist should be required to fill any valid perscription, inlcuding a perscription for birth control pills?

What do you all think of the

Submitted by DanMickelsonNJ on Fri, 04/10/2009 - 15:43.

What do you all think of the new smear site over at christieiscorrupt.com? is there the potential for an upset in the making if all of that is true? (or at least gets out?)

One Question

Submitted by Repack Rider on Fri, 04/10/2009 - 20:10.

So I walk into the only hospital in twenty or fifty miles, and the person I expect to help me because my taxes help support this hospital and because I have no other options says, "I can't help you with that. My conscience, you know."

Do I:

(1) Punch that person's lights out and say, "Since I'm dying anyway, what's another day in hell?"

(2) Ask if they have any help unburdened by conscience?

(3) Suggest the moron get a job he can handle?

(4) Pull my Second Amendment protected Glock nine and ask which is more important, his conscience or his own health?

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They are not even paying

Submitted by joeAnne on Mon, 06/01/2009 - 16:35.

They are not even paying attention. How do you expect from them to listen? For example, look at the current situation of those who consume drugs. Do you see beeing built a special place for them to attend a heroin rehab?

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