I’m one of those wacky idealists for whom January 20th was a great day. But with those high hopes, I have some fairly high expectations of our new president, one of the first of which is to repeal the Church Amendment, an HHS directive allowing health care providers to abandon proper ethics without consequence.
I’ve done quite a bit of blogviating about so-called conscience clauses, the rules that would allow health care providers to deny patients care not because it is outside the standard of care but because it bothers the personal beliefs of the provider. In case my previous writings have been unclear let me say right off the bat that conscience clauses are an ethical abomination.
Let’s look, though, at how these are being used in the real world. Providers who refuse care based on their own beliefs seem to make decisions that disproportionately affect women. I know, I know, this may seem obvious to some, but let’s look a little more closely.
The rules are quite broad and will allow providers to refuse to do nearly anything, including referring to a provider who will provide the treatment. For example:
[The statute] prohibits the Federal government and any State or local government that receives federal financial assistance from discriminating against any health care entity (including both individual and institutional providers) on the basis that the entity refuses to (1) receive training in abortion; (2) provide abortion training; (3) perform abortions; (4) provide referral for such abortions; and (5) provide referrals for abortion training.
Theoretically, the HHS rules should apply to any provider with any set of beliefs, but certain beliefs are mentioned explicitly in the draft rules.
the Department proposes to define abortion as “any of the various procedures–including the prescription and administration of any drug or the performance of any procedure or any other action–that results in the termination of the life of a human being in utero between conception and natural birth, whether before or after implantation.”
Despite the fact that several conscience statutes protecting health care entities from discrimination have been in existence for decades, recent events suggest the public and people in the health care industry are largely uninformed of the protections afforded to individuals and institutions under these provisions. This lack of knowledge in the health professions can be detrimental to conscience and other rights, particularly for individuals and entities with moral objections to abortion and other medical procedures.
The draft goes on to list state laws that require health plans to give equal coverage to female contraception and emergency contraception (“Plan B”). Condoms, the only “male” form of contraception, are nowhere mentioned.
Sterilization: Sterilization in mentioned no fewer than 28 times in the draft document, although in this case, there is no mention of female vs. male sterilization.
The statues allow for providers to refuse to dispense medications, refuse training programs from setting their own standards for their professions (e.g. it would forbid OB/GYN residencies from requiring abortion training in any way), allow unethical doctors to give false information about abortion and birth control (including that some birth control is equivalent to abortion (sic)), and allows them to refuse to give further information to help a patient find an alternate provider.
It is clear to all but the most muddled of thinkers that these rules are aimed at protecting providers with fringe religious beliefs when they violate the ethics of their professions. It should also be clear that these rules affect women disproportionately. If women cannot obtain birth control, Griswold is meaningless. It is inconceivable to me that in a modern democracy, the federal government can get away with passing laws that clearly discriminate against women. It is less inconceivable that there are doctors out there who would violate our most sacred duties toward our patients to fulfill our own religious needs.