Obama weighs patient rights vs. doctor's conscience
The administration will soon decide whether to reverse Bush's 'conscience rule.'
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When seven states sued in January to block the rule, Illinois Attorney General Lisa Madigan told the Chicago Tribune, "If enforced, this regulation will disparately impact low-income, uninsured, and under-insured women who rely on [family planning] programs for their health information and services."Skip to next paragraph
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The states challenge the legality of the rule because it fails to define the services and procedures that would be affected, and it may undermine state laws that ensure access to essential medical care, including reproductive services.
Many people see the rule having implications for services in areas such as HIV drugs, infertility, sexually transmitted diseases, blood transfusions, and end-of-life care, as well as scientific research.
"Americans are sensitive to religious freedom, but polls show that some 80 percent say women should have access to birth control with a valid prescription."
A 2007 poll by Lake Research, a public opinion research firm, found that 80 percent of US adults say birth control should be accessible and that it should be dispensed by pharmacists "without discrimination or delay."
In a different but related matter, a federal judge on Monday criticized the Food and Drug Administration for bowing to political pressure from the Bush administration in 2006 when it limited distribution of the morning-after pill called Plan B to women over 18, and ordered the agency to make it available to women as young as 17. Conservatives object that teens could get the drug without a prescription or guidance.
Balancing competing rights
Though freedom of conscience is a basic American principle, most people recognize that no right is absolute. The questions is: How far do providers' rights extend, and how are they balanced with the rights of patients? This issue seems particularly clear in emergency care.
The NWLC says the Bush rule fails to adequately address the legal obligation to provide medical care in an emergency, or the patient's right to "informed consent."
In a case highlighted by CMDA as improper pressure on a doctor, a Texas physician who examined rape victims objected to the hospital requirement that the patient be given an emergency contraceptive. She refused to do so – and refused to call in another physician, saying that since the contraceptive was morally wrong, calling in someone else was just as wrong.
The doctor complained that she was threatened with possible firing.
In that case, "for a provider to say I can't do that because it violates my conscience seems appropriate; for them to prevent anybody else from being called in seems more questionable, but the matter should be considered," says David Gushee, professor of Christian ethics at Mercer University in Atlanta.
For an administration bent on finding common ground, the option seems to be to create a new set of modified regulations. Administration officials declined to comment on their plans.
They could face a prickly process, which might involve not only bringing the contending sides together, but defining that explosive term – abortion – not yet defined anywhere in federal law.