Wednesday, November 25, 2009

False Either/Or Frame of Provider Refusal (Conscience Clause).

Columbia Law School hosted a debate on November 9 about conscience clauses (more accurately called provider refusals) in medicine. You can read the story here, but here's a clip that ends with a stunning quote from Steven Aden, senior legal council of Alliance Defense Fund that gets at the false-choice argument Catholic medical facilities and their defenders are asking the public to make:

The issue of conscience objections in the medical profession gained increased attention when the Bush Administration, in its final days, promulgated a provider refusal rule. It expanded the right of health care workers and institutions to refuse to provide medical care, counseling, and referrals for religious or moral reasons.
Kolbi-Molinas is co-counsel in a lawsuit challenging the regulation. “The ACLU believes an individual's—as opposed to an institution's—religious objection to the provision of certain health care services should be accommodated to the maximum possible extent, so long as patients' rights, including their right not to be discriminated against, are not compromised as a result,” she said.
“Whatever their religious or moral beliefs, health care professionals should ensure patients receive complete and accurate information, obtain appropriate referrals, and secure immediate care in an emergency.”
Reasonable delays in non-emergency situations—for example, having to wait at a pharmacy to receive emergency contraception while a pharmacist, who objects to the use of emergency contraception for religious reasons, gets another pharmacist to dispense the medication—are a reasonable accommodation of providers’ beliefs, Kolbi-Molinas said.
This controversy flared in New York in July, when a Catholic nurse sued Mount Sinai Medical Center for allegedly being forced to assist in a late-term abortion procedure. Aden, who is co-counsel in that case, found some common ground with Kolbi-Molinas regarding the conscience rights of individual providers. But he cautioned that health exception provisions are too broad and could threaten conscience rights.
Moreover, Aden said institutions, such as Catholic hospitals, were also entitled to conscience protections when it came to refusing to perform abortion procedures, and expressed concern for pharmacists who are pressured to provide emergency contraception against their beliefs.
"One in six Americans receives health care treatment at a Catholic hospital,” Aden said Are we really intent on risking the damage that would result to the health care system if Catholic providers pulled out of the market rather than violate their fundamental religious convictions?"
The US government, while allowing Catholic and other religious health care providers to maintain tax exempt status and to receive 50% of their funds from state and federal Medicare and Medicaid programs, permit these entities to dictate, according to religious doctrine, what services patients receive. The government has done little to protect patients rights.

"Pro-life" policies which restrict much more than abortion, including sterilizations, lesbian or unmarried women's fertility treatments, tubal ligations, end of life advance directives, contraceptives, and HIV and STD prevention, are imposed on 1 out of 5 patients in the US.

These "pro-life" entities are framing the argument as an either/or. Either you let us continue our restricted service of 20% of the population's health needs or you prepare for us to pull out of health care altogether. Groups like The MergerWatch Project have proven that compromises can be made. By mediating Catholic-secular hospital mergers, they work to prevent the erosion of informed consent, provider refusal of a patient's needs, and sole-provider hospitals from dictating to entire communities what health choices are available.

In other words, Catholic and other religious hospitals and health care networks are playing a game of no-compromise hardball. They refuse to make referrals, refuse to properly inform patients, refuse to honor patients' rights and refuse to address statistics regarding the benefits of the services they don't provide. They pretend they have the US population over a social services barrel when really they are working to impose their ideology on the country. It's a mission. The government should protect patients' rights, requiring these monopolizing organizations to compromise for the service of the public, tax exempt status, and informed consent, and forget the barrel.

Today CNN reported that the White House will address provider refusals (or conscience clauses) on Friday.

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