Conscience protection rule: pros and cons. A doctor’s opinion.

by James Hubbard, M.D., M.P.H.

Let’s face it.  The conscience protection rule is all about abortion.  It could be called the abortion protection rule.

It’s a regulation the Bush administration issued that applies to employers who receive federal funds. It ensures that they respect employees’ right to refuse to participate in medical treatment that goes against their conscience.  In other words, they can’t be forced to do things they think are wrong.  They can’t be fired for refusing to go against their beliefs. They can’t be fired for not participating in abortions.

You can read the full 31 page pdf file at the Federal Register.  Depending on whom you ask, it’s a step backward or a step forward, too broad or too narrow.  Pro-life groups love it.  Pro-choice groups abhor it as much as the NRA hates gun regulations.

But what are the pros and cons of the conscience protection rule?  That partly depends on what you believe as fact or fiction.

Fact or Fiction?

  • Employees, pharmacists, physicians and other health-care providers are being forced to go against their religious beliefs and conscience to participate in abortions and other related birth-control procedures.

Are they really?  Did they know what they were getting into when hired?  Personally, I can’t see that I could be forced to perform a procedure that goes against my beliefs.  But stranger things happen.  For instance, I don’t think physicians-in-training should have to participate in abortions if it’s against their beliefs.  Do they?  I don’t know.

Fact or Fiction?

  • The rule will hurt the lower-income people who have less access to health-care alternatives and will keep patients from getting full information on all birth-control options.

Will it really?  Planned Parenthood and other organizations that treat so many now will still be around, unchanged.  I think most women already know there is the option of abortion.  Besides, health-care professionals will still feel obligated to give a list of options.  It doesn’t mean you recommend or have to participate in the decision.

Fact or Fiction?

  • Some critics are even saying the rule will keep rape victims from getting proper treatment in the ER.

I don’t see that happening at all.  Despite our beliefs, physicians carry the responsibility for the best care for the patient.  If the treatment goes against their beliefs, they will find someone as an alternative, or have another staff member on call.

Overall, I see it as a good rule.  As in all these regulations, courts will decide the particulars (think Americans with Disabilities Act).  Come to think of it, employees must be able to do essential functions of a job, with or without reasonable accommodation, in order to keep their job.  Then again, what about freedom of religion?  Should that not be accommodated also?

What do you think?

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6 Responses to “Conscience protection rule: pros and cons. A doctor’s opinion.”

  1. Judy Rodman Says:

    Great, thoughtful post on a difficult topic!

    I am pro-choice (though personally anti-abortion), but for me, that means also pro-choice of whether or not to provide services or perform procedures such as abortion. It’s amazing to me that people can raise the roof about THEIR freedom of choice without seeing the need to grant that freedom to others.

    Perhaps it should make a difference whether an institution (such as hospital) is privately or publicly funded. Anyone going to work there should understand beforehand the policies that he or she would have to support.

    Judy Rodmans last blog post..Power, Path & Performance vocal training reviewed and vocal production tips shared

  2. James Hubbard, M.D., M.P.H. Says:

    Thanks Judy, I assume that any hospital that accepts Medicare/Medicaid would be considered publicly funded. I don’t know for sure.

  3. Steve Parker, M.D. Says:

    You’re fearless, Dr. Hubbard. This is a tricky issue.

    I generally think people should not be forced to do something on-the-job that violates their religious or ethical principles. For example, some Muslim cab drivers will not transport pet or seeing-eye dogs with their owners, nor will they transport someone carrying alcohol. For religious reasons.

    Fine with me if that cabby turns down fares.

    But if I own the cab company and that driver is hurting my profit margin, I’d be wishing that driver worked for someone else. Can I fire him without incurring a religious-descrimination lawsuit. Maybe not. Can I make it clear, in writing, before hiring him that such fares cannot be turned down, then fire him if turned down?

    Lawyers, judges, and juries will be answering these questions, at great expense.

    Reasonable people with options just won’t accept a job that challenges their religious and moral principles daily.

    Steve Parker, M.D.s last blog post..Bariatric Surgery Versus Diet and Exercise

  4. jhubbard Says:

    Thanks Dr. Parker,

    It depends on your frame of reference doesn’t it? If you are an employee, you don’t want to be forced into a situation. If you are an employer, you don’t want someone else telling you who you can fire.

    I would think an employer might have essential fuctions in writing, such as, will be required to participate in abortions, or prescribe birth control pills, etc. I don’t know how much you can legally assume. For instance, for me, I would assume that I worked in a pharmacy, I would sell birth control products, if I work in the ER I will have to treat rape cases, if I work for Planned Parenthood, I would participate in all sorts of birth control.

    But what about OB/GYN in training? Since there is a lot more to the specialty than abortions, should they not be able to opt out of it in training?

  5. Dr. J Says:

    I can’t imagine any doctor liking to do abortions.

    Consider this unusual question:

    What about a doctor refusing to prevent a miscarriage, which would naturally happen if no medical intervention was done?

    Dr. Js last blog post..Nibbles: Leptin gets another shot as obesity treatment, diabetes and mental function and screen time and unfit kids

  6. James Hubbard, M.D., M.P.H. Says:

    Dr. J,
    There are so many ethical dilemmas in medicine. Makes me glad I am not an OB?GYN

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