Health care and the conscience clause

Discussion in 'Ethics, Morality, & Justice' started by Tiassa, Jan 23, 2009.

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Health care providers _____ have the right to refuse to correct their "mistakes".

  1. should

    16.7%
  2. should not

    83.3%
  3. Other

    0 vote(s)
    0.0%
  1. Tiassa Let us not launch the boat ... Valued Senior Member

    Messages:
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    A looming question for the last few years, at least, is whether or not a medical services provider—doctors, nurses, pharmacists, &c.—have the right to refuse certain treatments and procedures for reasons of conscience.

    If you're a doctor with a private practice, it is simple enough: If you're anti-abortion, don't include abortions among your services.

    But beyond that, questions still persist. A lawsuit has arisen in New Mexico regarding the right of care providers—in this case, a nurse practitioner named Sylvia Olona, at Presbyterian Medical Services in Albuquerque—to ... well ... here:

    A woman in Albuquerque, N.M., went to a local health clinic to have the long string of her IUD shortened. No big deal -- all it takes is a simple snip. The nurse prodded her with a speculum and then, inexplicably, began pulling on the IUD, causing her sudden, intense pain. Then the nurse said one thing you never want someone to say when they have their hand in your vagina: "Uh-oh!"

    Surely, the patient must have been terrified -- but then the nurse offered an explanation: "I accidentally pulled out your IUD. I gently tugged and out it came ... I cut the string than went back and gently pulled and out it came. It must have not been in properly." That might have been somewhat reassuring -- oh well, accidents happen -- only, the nurse continued to explain that "having the IUD come out was a good thing" and then offered, "I personally do not like IUDs. I feel they are a type of abortion. I don't know how you feel about abortion, but I am against them."

    Hmm. The nurse continued: "Everyone in the office always laughs and tells me I pull these out on purpose because I am against them, but it's not true, they accidentally come out when I tug." Kidding about removing patients' birth control against their will? Hilarious -- sign me up for a visit to your office! Also: It's happened enough times that you have a reputation for it? Despite this being her "mistake," the nurse refused to insert a new IUD.


    (Clark-Flory)

    The lesson here, of course, is that women should avoid medical institutions with religious affiliations. But how far are we from a blacklist? Imagine the reaction when feminists and women's organizations begin circulating lists of health-industry institutions to be avoided.

    Should providers be required to submit statements of conscience to insurance companies, so that lists can be distributed to patients? It seems rather important in choosing a health provider.

    Perhaps doctors, in meeting new patients for the first time, should expect to be peppered with all sorts of obscure "what if" questions. It's hard to imagine every possible scenario, after all, and if it happens one day that a doctor refuses to provide expected services, well, whose fault is that? The patient should have asked before it came up, right?

    And if I am a pharmacy owner, can I set hiring criteria? Should I? Imagine:

    Owner: Just a few more questions, and then we'll be done.

    Candidate: (anxiously) Okay.

    Owner: Issues of conscience have become a more common conflict in providing health care. Are there any circumstances under which you would be unwilling to provide properly-prescribed medication to a paying customer? Are there any medications or products that you would refuse, for conscience reasons, to provide?

    Candidate: As a Christian, I cannot dispense Plan B.

    Owner: (pauses thoughtfully) Okay. Thank you. We'll be in touch. My secretary will show you out.

    And that's it. Done. Over. This is health care, not beer or ice cream sales. If you're going to refuse to do your job, I don't want you here.

    And then, of course, the candidate might file a lawsuit. ("As soon as I said I was a Christian, he ended the interview. I was obviously not hired because of my religion.")

    Health care is an important, even vital part of our society. It seems to me that if you enter a certain specialized field, and are aware of the demands it makes, one ought not decide later to back out because of conscience. While it is understandable that a Christian-affiliated hospital won't provide abortion services, just how far should conscience clauses reach?

    (It should also be pointed out that Olona's contention that IUDs cause abortions is not true.)

    As "godless liberal" P. Z. Myers noted, "Ladies, welcome to your future."
    ____________________

    Notes:

    Clark-Flory, Tracy. "Oops, I accidentally pulled out your IUD!" Broadsheet. January 22, 2009. http://www.salon.com/mwt/broadsheet/feature/2009/01/22/iud_abortion/index.html

    Myers, P. Z. "They have a conscientious need to control your ovaries". Pharyngula. January 20, 2009. http://scienceblogs.com/pharyngula/2009/01/they_have_a_conscientious_need.php
     
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  3. Balerion Banned Banned

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    I am firmly against people refusing health care based on their religious beliefs, but not entirely because I think religion is BS. It's mainly because I work for a major health care provider, and I see every day how hard it is for people to get their prescriptions without being turned down for "moral" reasons.

    Every year, health care providers raise their copays and coinsurances. They exclude drugs from their formularies despite not having any suitable alternatives on the formulary, either. They have a process called "Prior Authorization" where the doctor has to make his/her case to the insurance company as to why the patient needs a certain medication...as if the fucking prescription they wrote wasn't authorization enough. And sometimes it doesn't matter what the doctor says, the medication won't be approved, and the patient will have to pay full-shot out of pocket.

    I spoke with a woman the other day that needed a certain medication a certain way, or else she risked losing her pregnancy. She had her prior authorization request turned down three times--once for the original request, and then three appeals--and she simply could not afford it on her own.

    So it's hard enough for folks to get their medication. The last thing we need is thick-headed zealots refusing services based on their mythology. And the kicker, at least to me, is that they'd choose to be in the health care field (even if it's just being behind the counter at a pharmacy) if they're uncomfortable with selling certain products. Why work there, then? Why hire them, then?
     
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  5. Challenger78 Valued Senior Member

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    You're going to refuse help to someone else because of "your" moral reasons?. Isn't that a touch selfish ?
    I agree with JDawg. Don't work in an industry that may test your conscience, unless your prepared to deal with it. I wonder how journalists survive.
     
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  7. Balerion Banned Banned

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    By crushing those they disagree with. Every watch Fox News?
     
  8. Challenger78 Valued Senior Member

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    Yes, but I've also seen Robert Fisk and John Pilger win arguments fairly.
     
  9. swarm Registered Senior Member

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    If you have religious objections to being a health care professional, get the fuck out.
     
  10. Nasor Valued Senior Member

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    People should be free to not perform any services that they find objectionable, employers should be free to fire employees who don't do their job, and people should be free to choose a service provider that will meet their needs. The only problem here seems to be the confusion and annoyance that occurs when patients find out that their healthcare provider doesn’t offer all the services that they thought they offered. I don’t see any issues with a vegetarian accountant refusing to do the books for a steak house, or an environmentalist construction worker refusing to build a saw mill for a corporation that clear-cuts forests.

    Of course, what’s described in the OP is quite different from simply refusing to provide certain procedures. It sounds more like assault.
     
  11. swarm Registered Senior Member

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    4,207
    Health care is not accountancy.

    Pharmacists refusing to fill a Doctor's perscription because its "offensive" to them or Nurses covertly ripping out medical devices is not refusing to do the books of a steakhouse.
     
  12. Balerion Banned Banned

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    We're not talking about a drug store refusing to sell birth control pills (though I disagree with that, as well). We're talking about health care refusing services based on faith. Don't get in the business of providing health care if you can't provide all of the services.
     
  13. swarm Registered Senior Member

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    4,207
    The health of the patient is the pre-eminant concern, not the personal preferences of the health care provider.
     

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