Feature Story - February 2009
"Conscience" Protections Afforded to Health Care Workers
While the rule is aimed primarily at shielding those with religious or moral objections to abortion or sterilization, its scope could be much wider, including those opposed to assisted suicide, family planning, sex change operations or vaccinations.
The Department of Health and Human Services last month approved the Provider Conscience Regulation, a federal rule that protects a broad range of health care professionals who refuse to participate in providing services such as abortions, because of moral or religious objections.
The rule took effect on Jan. 18th, two days before the end of the Bush administration.
The regulation allows federal health officials to cut off federal funding for any state or local government, hospital, clinic, health plan, doctor's office or other entity, if it does not accommodate health care employees who exercise their "right of conscience."
The measure, which applies to more than 584,000 health care facilities, gives them until Oct. 1st of this year to provide written certification of their compliance. Those that do not comply face the prospect of having their funding cut off or being required to return funding they already received.
HHS officials said, the 127-page regulation, which will cost nearly $44 million to implement, is aimed at alleviating a trend of isolation and exclusion of people of faith from the healthcare industry.
Bush administration HHS Secretary, Michael Leavitt, said, "Doctors and other health care providers should not be forced to choose between good professional standing and violating their conscience. This rule protects the right of medical providers to care for their patients in accord with their conscience."
HHS issued a statement that read, in part, "Over the past three decades, Congress enacted several statutes to safeguard the freedom of health care providers to practice according to their conscience. The new regulation will increase awareness of, and compliance with, these laws.
The Department also encourages providers to engage their patients early-on in full, open and honest conversations to disclose what services they do and do not provide."
The 16,000-member Christian Medical Association hailed the new rule.
Association CEO, Dr. David Stevens, said, "By protecting physicians and other healthcare professionals who still adhere to the Hippocratic Oath, the Judeo-Christian Scriptures and other objective stands or medical ethics, this regulation serves to protect patients who want access to conscientious and compassionate care from life-affirming physicians. These objective standards have for millennia formed the foundation of patient care and protection, and this regulation insures that physicians and others won't be run out of the profession for upholding those standards."
Stevens noted that 41 percent of CMA members responding to a survey reported being "pressured to compromise Biblical or ethical convictions."
"Physicians report being forced out of medical positions, residents report loss of training privileges, and students report discrimination in medical school admissions," Stevens added.
Michael McMonagle, president of Pro-Life Coalition of Pennsylvania, said, the rule was enacted because medical organizations were threatening to revoke the licenses of obstetricians and gynecologists who refused to provide abortions or refer patients to others willing to provide abortions.
McMonagle said, "Pro-lifers didn't pick this battle."
Likewise, the U.C. Catholic Conference of Bishops welcomed the regulation.
Deirdre McQuade, the bishops' spokesman on abortion, said, "Individuals and institutions committed to healing should not be required to take the very human life that they are dedicated to protecting. The enforcement of federal laws to protect their freedom of conscience is long overdue.
Catholic health care providers will especially welcome this mark of respect for the excellent life-affirming care they provide to all in need. But Catholics do not stand alone in opposition to the deliberate destruction of nascent human life. All health care providers should be free to serve their patients without violating their most deeply-held moral and religious convictions in support of life," McQuade said.
Some conservative groups, like Family Research Council, also praised the new rule.
FRC President, Tony Perkins, said, "This is a huge victory for religious freedom and the First Amendment. No one should be forced to have an abortion, and no one should be forced to be an abortionist. These regulations will ensure that conscience protection statutes will be strongly enforced by the government in the same manner as our other civil rights laws.
Protecting the right of all health care providers to make professional judgments based on moral convictions and ethical standards is foundational to federal law. These regulations will implement conscience protections that have been embodied in U.S. statutes for over three decades. This is also a victory for the right of patients to choose doctors who decline to engage in morally objectionable practices.
The lack of regulation has resulted in confusion and a lack of awareness within the health care community regarding the statutes, leaving health care personnel vulnerable to discrimination, and forcing them to drop their specialties at a crucial time of health care scarcity," Perkins stated.
Concerned Women for America underscored the timing of the regulation.
CWA President, Wendy Wright, said, "Abortion groups are desperate to change the topic from abortion to birth control, and to deny health care providers the right to choose not to commit abortions. Forcing doctors, nurses and other health care providers to commit abortions would drive pro-life professionals out of the profession at a time when we need more doctors and nurses. It would deny patients the ability to choose doctors and health care providers who share their strong moral views. Many patients cannot trust their health to a doctor or nurse who commits abortions," Wright said.
The American Nurses Association says, it already has a code of ethics in place, in which it believes patients should make decisions on care based on their own beliefs–not those of the health care provider.
ANA Director of Nursing Practice and Policy, Mary Schumann, noted, "We don't make God-like decisions. That's not what it's about for us. It's about helping the patient make their own decisions. No one appointed us to be the ultimate person to pass judgment."
Planned Parenthood Federation of America, in a statement, said, "Roughly 200,000 U.S. citizens, federal and state elected officials, medical organizations, and health care advocacy and religious organizations submitted comments opposing the misguided rule. The regulation broadens the scope of existing laws and reaches beyond congressional intent by focusing solely on providers, with absolutely no protections to ensure patients receive critical health care information and services."
Planned Parenthood President, Cecile Richards, added, "This midnight regulation, issued in the last days of the Bush Administration, undermines this country's fragile health care system, as well as patients' access to health care information and services.
With more than 45 million Americans currently uninsured, this is no time to make access to health care even more difficult. In addition, this rule could potentially create total chaos in an already-stressed health care system, particularly for low-income women and families whose options are already limited," Richards said.
Catholics for Choice criticized the rule.
Organization President, Jon O'Brien, said, "The conscience, or more correctly, refusal clause regulation issued by the Bush administration attacks the health options open to women and men throughout the United States.
Promoted by the anti-choice movement, and under the guise of protecting religious freedom, this clause now serves as a means for medical professionals to opt out of providing essential reproductive health-care services and medications. It will be the poor and powerless who will be most affected by this draconian measure," O'Brien said.
The Religious Coalition for Reproductive Choice also took issue with the regulation.
RCRC President and CEO, the Rev. Carlton Veazey, said, "This is an ideological measure and a troubling end to the Bush administration's sad legacy on women's health. Not only is it a final blow against women's reproductive health needs, but also, it will inflame the divisiveness over abortion as the Obama administration begins its tenure."
In addition, the RCRC was among 63 medical, public health, research, religious and religiously-affiliated, women's health, legal and other advocacy organizations which presented a document to the Obama transition team, "Advancing Reproductive Rights and Health in a New Administration."
Priorities cited in the document include "improved access to abortion care" and "reclaiming America's global leadership on reproductive health."
In response, Catholic League President, William Donohue, said, "From the very beginning, the pro-abortion industry has not only opposed any religion which is pro-life, it has adopted a confrontational approach. This document is no different. But when religious organizations give their assent, it is troubling.
"Look for traditional Catholics, Evangelical Protestants, Orthodox Jews and others to come together in an unprecedented way," Donohue said.
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