Hours before President Barack Obama prepared to take office on Jan. 20, 2009, the Bush administration put a new law into effect allowing healthcare workers to refuse patients certain procedures and information on the grounds of religious or moral objection. The new Provider Refusal Rule expanded on the “conscience clause” of a 30-year-old law that had been in place to protect healthcare providers declining to perform abortions. The new law allows healthcare workers “from doctors to janitors” to withhold “services, information or advice” from patients on family planning, contraception, blood transfusions or other procedures they may find morally contentious.
The Provider Refusal Rule, however, may be short-lived.
According to a Reuter’s report, the Obama administration formally announced its plans to rescind the law in February, but is still in the process of reviewing the regulation. Repealing the law would be good news for many health organizations, like the American Medical Association, that believe healthcare professionals have an obligation—regardless of their personal views— to advise their patients of all health options available to them.
Not everyone has been happy about the new administration’s announcement, however. Criticism has come from the religious and medical communities alike. According to a Catholic News Service article, forty doctors, physician assistants, pharmacists, nurses and other healthcare professionals held a joint press conference at the National Press Club on April 8 denouncing the Department of Health and Human Services’ plans to undo the conscience regulation.
The press conference was hosted by Freedom2Care, a coalition of 36 medical and secular organizations “dedicated to protecting conscience rights.” Freedom2Care, along with the Susan B. Anthony List, a pro-life political women’s organization, launched a campaign to file 36,000 complaints against the Obama administration’s repeal. The U.S. Conference of Catholic Bishops’ National Committee for a Human Life Amendment filed another 35,000 comments against the repeal.
Criticism has also come from within the Obama administration.
A letter submitted to HHS by Nathan Diament from the Union of Orthodox Jewish Congregations included the signatures of four members on Obama’s Office of Faith-Based and Neighborhood Partnership Advisory Council, including Sojourners president Jim Wallis,
As the media and political debates continue, the question still holds: can healthcare professionals have a conscience under the law? Critics of the repeal argue that getting rid of the Provider Refusal Rule would jeopardize healthcare providers’ right to practice their profession while staying true to their moral convictions, and would therefore, violate their First Amendment right to free exercise of religion. Critics of the rule, however, say that the conscience regulation as it stands sanctions denying patients services they may want or need. They further argue that accepting or declining certain procedures or health options should be left to the conscience of the patient, not the doctor. In the end, the debate on whether or not to rescind the Provider Refusal Rule seems to be pitting patient rights against healthcare provider rights. The debate is also a broader one of religion and politics. Does the government have the right to tell physicians and nurses to drop their consciences at the hospital door? If not, does the government still have a responsibility to ensure that physicians are transparent with patients about all options open to them?
It seems to me that the government does not have the right to dictate doctor conscience, but patients should also be informed if certain information about their health is being withheld from them. Strikingly a balance between the two, however, has proven difficult. So as the revision of the Provider Refusal Rule moves forward, the Obama administration will continue to stand in the middle of an ongoing tug-of-war between the right to know and the right not to tell, the right to care and the right to conscience, the responsibility to the patient and the responsibility to the doctor. In the end, whether the administration decides to repeal or reaffirm this new conscience regulation, it is unlikely that the heated debates over provider conscience will be simmering down anytime in the near future.
Related CNN video: "Healthcare's moral debate"