24 September 2008

Speak out now

In their continuing war against women's reproductive rights, HHS Secretary Leavitt has proposed a new federal regulation which would allow healthcare providers to refuse to provide any service they deem would violate their personal values.

Now let's be clear: this is not about abortion. There already exist in many other statutes -- federal and state -- ample protections for OB/GYNs who do not wish to perform terminations. That's not at issue here, the Secretary's claims to the contrary notwithstanding. This is entirely intended to reinforce the Christian right's effort to redefine contraception as abortion, specifically post coital contraception, also known as "Plan B" or the "morning after pill." Under this rule, which applies essentially to all hospitals nationwide (as recipients of CMS funds), the ER doctor could deny rape victims access to emergency contraception, and in fact could even withhold the information that Plan B is an option to a woman who is unaware it exists! This rule would also allow hospitals to declare it their policy that Plan B will not be prescribed from their facility, and HHS would accept this as an "institutional health care provider's" conscientious objection.

While in many settings this would not impact women's access to this service, in areas where there are no alternative facilities to refer patients to, or in conservative regions where all the facilities might adopt this conscience clause, then this rule may allow a de facto abolition of a woman's right to choose post-coital contraception.

The Department will be accepting comments for the next two days on their web site. Take a moment to express your objections.

Some general principles I would endorse:

  • The welfare of the patient must be at the center of medical decision-making and treatment.
  • The religious/moral beliefs of a caregiver or religious doctrine of a health care institution cannot be allowed to obstruct a patient's access to care.
  • Patients must be able to make treatment decisions based on accurate medical information and their own ethical or religious beliefs. No information may be withheld.
  • Health care institutions must provide emergency care immediately, without exception.
  • For non-emergency care, referrals must be made if treatment is refused.
  • The ability of non-objecting health practitioners to serve their patients must be safeguarded. No physician "gag rules" should be allowed.
The anti-choice zealots out there like to say that " health care providers shouldn’t have to check their conscience at the hospital door." With respect, they are wrong. As a physician caring for the vulnerable, when options are limited, I must subordinate my personal opinions to the values and welfare of the patient. I often do not approve of my patients or their choices. That is immaterial; it is not my role to be their pastor or for me to impose my moral code onto them.

To put it more simply, while I may have my opinions (and I certainly do), patients come first.


  1. I wonder how long it will take for someone to deny care to a transgendered individual, to a homosexual, to a well known atheist, because it's in contravention of their ideological beliefs.

  2. This has happened in the UK where a pharmacist refused to give a patient the morning after pill as it was against her own beliefs.
    full article here

  3. I strongly agree with you on this!!!

  4. That is very scary to me. As a previous commenter mentioned, it is probably just a matter of time til we start refusing care to people for other reasons. Or to people with no insurance, for that matter. It sets a frightening precedent.

    (Hi, by the way. I'm Becky and I'm new here.)

  5. What happened to the separation of church and state? D*mned fascist evangelicals.

    We may as well just burn the constitution, repeal suffrage, and take away the shoes of every woman of reproductive age.

  6. No narcotics for lawyers?

  7. Maybe lawyers should help fund universal healthcare from the proceeds of all the class action suits they keep filing against pharmaceuticals and bogus malpractice action that ends up getting settled out of court. Heaven knows, the bulk of the money goes into their pockets, anyway.

    Having said that, I must confess the oldest daughter is a pre-law student. Fortunately, she's rabidly progressive and not the least bit interested in ambulance chasing.


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