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| The new HHS division implements 25 federal conscience laws |
Editor's Note: This is the sixth essay in a series on conscience in healthcare, by Freedom2Care Director Jonathan Imbody. For the other essays, click "ConscienceEssay" on Topics at left.
In January 2018, the U.S. Department of Health and Human Services announced the creation of a new division within its Office of Civil Rights—the Conscience and Religious Freedom Division.[i] The new division now serves as a center for information on 25 federal conscience laws, outlined on the division's website, including:[ii]
·
The Church Amendments, enacted in the
1970s "to protect the conscience rights of individuals and entities that
object to performing or assisting in the performance of abortion or sterilization procedures if doing so would be contrary
to the provider’s religious beliefs or moral convictions."
·
Public Health Service Act § 245, which "prohibits
the federal government and any state
or local government receiving federal financial assistance from discriminating against any health care
entity on the basis that the entity refuses to undergo training in the performance of induced abortions" and related actions.
·
The Weldon Amendment, which prohibits government
"discrimination on the basis that the health care entity does not provide,
pay for, provide coverage of, or refer for abortions."
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| The HHS division will help victims like nurse Cathy DeCarlo, forced to participate in an abortion against her conscience. |
"We are thankful to see these vital conscience freedoms restored in healthcare," noted Christian Medical Association Senior Vice President Gene Rudd, MD in a news release. "For millennia, medical ethics have provided for conscientious opposition to abortion by physicians who took up the practice of medicine as a healing art never to be used for the destruction of human life. And until recently, our government reinforced those ethical principles with conscience protections. We are heartened to see our government heading back in the direction of these vital freedoms that protect patients, medicine and freedom in our country."
In that news release, I added, "As Americans who have inherited a nation founded upon freedom of faith, conscience and speech, we can agree that the government must never force individuals to violate their deepest held beliefs on vital and extremely controversial issues such as abortion. When our leaders forget these principles, and take to forcing nuns to participate in matters they consider wholly immoral, the American people realize that our fundamental freedoms are in jeopardy. If the government can take away the rights of one group, then no one is safe from government coercion.
"These actions today by the administration are an important step back in the direction of freedom and respect for one another, and we look forward to more actions in the future, including restoration of the conscience rule for health professionals that President Obama gutted."
While many lauded the new division as protecting
fundamental conscience freedoms and First Amendment rights, some political
activists issued "hair-on-fire" statements condemning the division as
devaluing humanity and promoting religious bigotry.
"This is the use of religion to hurt people because
you disapprove of who they are," asserted Harper Jean Tobin, the National
Center for Transgender Equality's director of policy, in a statement published
by The Washington Post.[iv]
No one's objecting to treating "particular
classes of patients"
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| Contrary to unsubstantiated claims of conscience freedom covering bigotry, faith-based professionals often actually seek out marginalized and stigmatized patients. |
Writing in the New
England Journal of Medicine, Obamacare architect Ezekiel Emanuel and Penn Professor
Ronit Stahl also equate conscience objections with bigotry, asserting,
"No matter how sincerely held, objections to treating
particular classes of patients are indefensible — regardless of whether the
objections are based on race, gender, religion, nationality, or sexual
orientation."[v]
Well, sure, that would be indefensible—if it were actually happening. But, of course, the
authors provide no examples of such insidious discrimination. It's just useful
for stirring up an emotional response: " I don't want to be labeled a
bigot, so let's get rid of these conscience laws that legalize bigotry!"
When President Obama gutted a two-year-old Bush-era
conscience protection regulation, an opponent of conscience rights exclaimed to
the Washington Post, "Without
the rescission of this regulation, we would see tremendous discrimination
against patients based on their behavior and based just on who they are. We would see real people suffer, and more women could die."[vi]
Of course, no real-life examples were cited, and apparently
none occurred in the years after the conscience protections took effect.
The truth is that conscience protections do not allow
physicians to refuse to treat "particular class of patients." In fact,
faith-based health professionals (who depend on conscience protections against
coercion) in particular have gone to great lengths to purposefully reach out to
the marginalized, the stigmatized and victims of discrimination.
Health policy will always reflect opinions
 |
| Hypocrisy: Abortion advocates agitate to force pro-life physicians to participate in abortion. Then they accuse conscientious objectors of forcing their personal opinions on others. |
While real-life examples of medical professionals
"devaluing the humanity of LGBTQ people" are scarce or nonexistent,
examples of personal opinions impacting healthcare are ubiquitous. It's also notable
that at the same time that Ms. Warbelow argues to disallow the "personal opinions"
of health professionals from influencing healthcare, she argues that her own
personal opinion, her group's own ideology, must direct healthcare.
Opponents of conscience protections frequently assert the
mantra that conscientious health professionals are forcing their opinions on
others. But prolife physicians do not force their patients or anyone else to adopt
a prolife view; they simply seek exemption
from coercion to kill.
Yet intolerant abortion advocates cannot seem to
countenance diversity of opinion in healthcare. They would force prolife
physicians to perform or refer for abortions or else sacrifice their careers.
Then they complain with straight faces about prolife physicians forcing their opinions
on others.
The idea that health professionals must ignore their moral
and ethical convictions and perform any and all legal procedures is, in itself,
a personal opinion expanded into an ideology—"an
orientation that characterizes the thinking of a group or nation."[viii]
The conscience debate will impact the future of healthcare
In a free society, we can and should debate the question: Would eliminating conscience freedoms be good or bad for healthcare, for patients, for health professionals, for the country? But to assert that health professionals who base their practice of medicine on certain ethical prohibitions are uniquely forcing their "personal opinions" on others is patently hypocritical.
Healthcare policies always
reflect opinions; they are conceived and implemented by individuals who have
personal opinions and by groups that have ideologies. Our democratic republic
is designed to debate opinions freely and then translate the best opinions into
laws that benefit society. We elect lawmakers who share our opinions and will
translate those opinions into laws and policies.
For example, the law that imposed Obamacare on the nation clearly
reflected the opinions and big-government ideology of Democrats. The repeal and
replacement of Obamacare clearly reflected the opinions and small-government ideology
of Republicans. Even if Congress decided to get out of healthcare altogether, that
decision to disengage would be a policy formed by opinions and ideology.
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| The real question is not whether a policy reflects someone's opinions but rather which opinion, which policy is best and should prevail? |
For millennia, medicine and law have provided room for conscience
freedom--differing convictions on controversial issues--among health
professionals. Many would continue that long-standing policy of tolerance for reasons
both pragmatic and philosophical:
·
Tolerance maximizes healthcare access by enabling a breadth of professionals to practice
medicine;
·
Tolerance comports with professionalism and professional judgment (a health professional
being one who professes to adhere to an
ethical standard that guides his or her practice of medicine);
·
Tolerance offers patients the ability to choose
health professionals in line with the patient's own values;
·
Tolerance reflects core American principles of freedom of conscience, faith and speech.
The current debate, then, is not about "imposing
opinions"; it is about whether or not our long tradition of tolerance for
a range of ethical positions should be continued or discontinued. The result of that debate will significantly impact the future of medicine, healthcare access and religious freedom.
[iii] CMA news release,
"Christian Medical Association physicians laud new federal conscience rule
as protecting patient access to healthcare," January 19, 2018. Accessed online
Feb. 20, 2018 at https://www.cmda.org/resources/publication/christian-medical-association-physicians-laud-new-federal-conscience-rule-as-protecting-patient-access-to-healthcare.
[iv] "New HHS civil
rights division to shield health workers with moral or religious objections,"
The Washington Post, Jan. 17, 2018.
Accessed online Feb. 20, 2018 at https://www.washingtonpost.com/national/health-science/trump-administration-creating-civil-rights-division-to-shield-health-workers-with-moral-or-religious-objections/2018/01/17/5663d1c0-fbe2-11e7-8f66-2df0b94bb98a_story.html?utm_term=.d48820f23238.
[v] Stahl and Emanuel, p.
1383.
[vi] "Obama
administration replaces controversial 'conscience' regulation for health-care
workers," Washington Post,
February 19, 2011. http://www.washingtonpost.com/wp-dyn/content/article/2011/02/18/AR2011021807443.html
accessed 9/21/17.
[vii] Ibid.
[viii] Advanced English Dictionary definition.
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