HHS "PROVIDER CONSCIENCE": Bush Legacy

January 20, 2009 2:54 PM

On January 20, the HHS "Provider Conscience Rule" went into effect, allowing employees and volunteers at government-funded hospitals and clinics to deny patients access to a variety of medical services, based on moral objection. The Rule is one of the Bush Administration's parting midnight regulations. Ostensibly focusing on abortion and sterilization, it is considered by some to be written so vaguely that it might be applied to "contraception, fertility treatments, HIV/AIDS services, gender reassignment, end-of-life care, or any other medical practice to which someone might have a personal moral (not even religious) objection.”

The Attorney General's Office of Connecticut, joined by seven states, has filed a lawsuit to quash the regulation. Some background about HHS' Provider Conscience Regulation.

posted by terranova (31 comments total)

Ah, context.
posted by infinitewindow at 3:01 PM on January 20, 2009

End of life care?

Some doctor is going to decide how I spend my death based on THEIR religion?
Fuck that.
posted by Monsters at 3:10 PM on January 20, 2009

Now how do I go about finding a doctor who is demonstratably an atheist?
posted by Astro Zombie at 3:18 PM on January 20, 2009 [3 favorites]

Great.

"Can I have some more morphine? The cancer that is eating away at me has left me in terrible pain."

"Sorry. God told me that you need to suffer."
posted by alphathefish at 3:18 PM on January 20, 2009

Rip this out, threads and all.
posted by orthogonality at 3:25 PM on January 20, 2009

Thanks oh so ethical Representative Weldon for creating the amendment that drove this.
posted by BrotherCaine at 3:37 PM on January 20, 2009

We had a discussion on this months ago. The regulations defining the "Conscience Rules" are clearly contained in a section titled "Abortion and Sterilization" or something similar.

Also, most doctors are specialized in a certain area. So unless people are calling for doctors to be forced to perform operations that are not in their specialty, I'm unclear why the rule is needed in the first place. Are there really that many abortion doctors who refuse to do their job?
posted by jsonic at 3:41 PM on January 20, 2009

I remember one doctor at a Catholic university's hospital explaining to me that "now would be a good time to quit smoking, because Lent's about to begin".

I smiled and nodded, refraining from explaining that not only am I not Catholic, I'm not Christian.
posted by orthogonality at 3:42 PM on January 20, 2009 [1 favorite]

Related, sort of.
posted by exogenous at 3:44 PM on January 20, 2009

I'm unclear why the rule is needed in the first place. Are there really that many abortion doctors who refuse to do their job?

This Rule could have adverse affects (including physical harm) upon scores of patients. Two prior exemplary cases are cited here: a 42-year-old mother denied emergency contraception who became pregnant; and a 19-year-old woman who had a life-threatening pulmonary embolism, who was denied treatment at a religiously-affiliated institution which would not perform a first-trimester abortion.

And this New York study found that 29% of respondent hospitals would refuse on moral or religious grounds to abide by patients' wishes to withhold or withdraw life support.
posted by terranova at 3:57 PM on January 20, 2009

"... That could mean 14 percent of patients, or more than 40 million Americans, may have doctors who do not feel ethically bound to disclose information about treatments they find objectionable... And 29 percent of patients, or nearly 100 million Americans, may be cared for by doctors who do not feel they must refer patients to another doctor who would provide the service the patient requests."
posted by terranova at 4:09 PM on January 20, 2009

to which someone might have a personal moral (not even religious) objection.”

Oh, well, what could be more awful? People having moral beliefs without having signed up to a government-approved tax-exempt group with a collection of figureheads.

I think the regulation described is a pile of shit, and all, but I fail to see how it's ALL THE MORE AWFUL!!!!!1111!!!! because the morality in question does not appeal to an invisible guy in the sky.

Are there really that many abortion doctors who refuse to do their job?

Perhaps not, but there are certainly no shortage of chemists and nurses who will fuck up your attempts to be responsible with contraceptives.
posted by rodgerd at 4:30 PM on January 20, 2009

OK, I openly challenge all medical professionals who claim to oppose this rule (if it is as broad as feared, which I doubt) to deny routine care to Christians of any stripe, on the basis of personal moral objection.

...got a toothache? Oops, I see you're wearing a cross. Sorry, I'm morally opposed to the removal of impacted teeth. How unfortunate for you. No, sorry, I'm also morally opposed to sending you to another dentist. Funny how that works.
posted by aramaic at 4:42 PM on January 20, 2009 [1 favorite]

President Obama, Overturn the Global Gag Rule!
posted by homunculus at 4:43 PM on January 20, 2009

OK, I openly challenge all medical professionals who claim to oppose this rule (if it is as broad as feared, which I doubt) to deny routine care to Christians of any stripe, on the basis of personal moral objection.

Yeah, because all Christians support this kind of reactionary bullshit.

I'm an atheist, but there's plenty of historical precedent for narrow-minded patriarchal moral gotchas among atheists as well as people of faith. Sometimes religion is just the excuse of someone who would want to control your life because of their personality, and if you took away the religion there'd be some other kind of bullshit father-knows-best justification.
posted by BrotherCaine at 5:00 PM on January 20, 2009 [2 favorites]

Screwtape must be delighted with this turn of events. Way to use religion for the purpose of evil, President Bush!
posted by five fresh fish at 5:11 PM on January 20, 2009 [1 favorite]

jsonic: Well I think one of the areas it could have the biggest impact is more rural parts of the country where access to health care is pretty limited. If you have the choice of two doctors within a 100 mile radius and both happen to be staunchly against procedure X, Y or Z, but you don't even know this until you need it... well you're just screwed.

It is analogous to the pharmacist who refuses to fill a birth control perscrip (which has happened) because they are morally opposed to it. Not a huge deal in New York City, a pain in the ass sure, but you can go a few blocks to the other Walgreens and all will be taken care of. Rural Idaho?

This would seem to clearly violate any pretense to equal access to heath care.
posted by edgeways at 5:12 PM on January 20, 2009

Eh, I'm a fan of mutually-assured destruction. Create a law that attempts to punish some folks for the beliefs of others? Right-o, let's use it to punish everyone instead. Oops, suddenly it's not such a great idea.

Turnabout being fair play and all, even if it's not the optimal solution (which it isn't).

Let 'em see how the other half lives, so to speak. My goal isn't to reverse a single unfortunate ruling, it's to inflict sufficient suffering that an entire category of legislation becomes unpalatable. Which is probably immoral, but hey, I've never claimed to be moral.
posted by aramaic at 5:16 PM on January 20, 2009

this New York study found that 29% of respondent hospitals would refuse on moral or religious grounds to abide by patients' wishes to withhold or withdraw life support.

It's hard for me to put into words how much this bothers me. Yes, the reproductive rights stuff sucks, but extending this to palliative care is simply unacceptable. My father died shortly before xmas. His doctor explained to me that any attempts at resuscitating him or introducing life-support measures would leave him injured at best, and very likely brain-damaged.

What if this law had been in effect last month and the doctor on duty was morally opposed to withholding life support? Would we have had to see my Dad kept alive against his wishes until another doctor was available to end his suffering?!

Denying the right to a dignified death is the most immoral thing I can imagine.
posted by Monsters at 7:22 PM on January 20, 2009

Fortunately, Bush's last x days of idiocy are "on hold" during the transition period, so with any luck this BS won't actually make it into law.
posted by five fresh fish at 7:26 PM on January 20, 2009

Oh, why can't he just go quietly into dark peaceful night.
posted by countzen at 7:37 PM on January 20, 2009

got a toothache? Oops, I see you're wearing a cross. Sorry, I'm morally opposed to the removal of impacted teeth.

Oh, hey, yeah! 'Cuz that actually happens!

For Christ's sake
posted by dirigibleman at 8:15 PM on January 20, 2009

Fortunately, Bush's last x days of idiocy are "on hold" during the transition period, so with any luck this BS won't actually make it into law.

Indeed.
posted by potsmokinghippieoverlord at 9:00 PM on January 20, 2009 [1 favorite]

Oh, hey, yeah! 'Cuz that actually happens!

Not yet. That's the point.
posted by aramaic at 9:10 PM on January 20, 2009

Just to play devil's advocate here, we've accepted in this country that health care is to be handled by private businesses. Can't businesses refuse service to anyone they want, on any grounds? Where in the law is there a principle of equal access to health care?
posted by heathkit at 10:04 PM on January 20, 2009

Just to play devil's advocate here, we've accepted in this country that health care is to be handled by private businesses. Can't businesses refuse service to anyone they want, on any grounds? Where in the law is there a principle of equal access to health care?

Huge portions of health care providers' revenue comes from Medicare and Medicaid, thus subjecting them to the same hooks that prevent hospitals from refusing to treat black patients.

But I would like to see an equal-protection suit brought against providers who provide a lower quality of health care to the poor, based on a liberal reading of the 14th Amendment.
posted by Mayor West at 4:48 AM on January 21, 2009

Now how do I go about finding a doctor who is demonstratably an atheist?

He's the one that screams "Damn you! O meaningless void of existence that demands we choose our own moral and ethical guidelines, don't take this child, take me instead!"
posted by The Whelk at 5:27 AM on January 21, 2009 [2 favorites]

The last time I needed emergency contraception, I spent three hours waiting at a drop-in clinic only to be told that the doctor on duty refuses to dispense EC for "moral" reasons. I decided to take the appointment anyway, since I'd waited all that time, and actually had a good chat with the guy about why he (wrongly) considers EC an abortifacient. I was tempted to telll him that when I had my unwanted child, I'd know who to come to for support payments...
posted by Pomo at 9:00 AM on January 21, 2009

Can't businesses refuse service to anyone they want, on any grounds?

No.
posted by rodgerd at 2:22 PM on January 21, 2009

For First Time In Eight Years, President Supports Roe On Anniversary
posted by homunculus at 1:41 PM on January 22, 2009

Obama to Lift Global Abortion 'Gag Rule': Policy Forbid Funding of International Groups That Perform, Provide Information About Abortion
posted by homunculus at 1:50 PM on January 23, 2009 [1 favorite]