Speak Out To Protect Freedom of Conscience!

As budget and bailout concerns capture the news and the public attention, the Department of Health and Human Services is quietly making plans to throw out the conscience rules that protect medical workers who refuse to perform medical procedures contrary to their moral convictions. 1.

Following Roe v. Wade in 1973, state and federal conscience clauses were enacted to protect health care workers who didn't want to perform abortions. Subsequent protections developed to protect reluctant health care workers from participation in euthansia and assisted suicide.

THE PROVIDER REFUSAL RULE

In August of 2008, the Bush administration proposed legislation that was enacted into law on inauguration day of 2009. The Provider Refusal Rule strengthened protections for doctors, nurses and workers in health care settings who refuse to provide a medical service because of moral convictions.

This legislation also protects healthcare providers from being involved in additional procedures, like sex change operations and assisted suicide, as well as vaccinations and family planning, if they are morally opposed to the procedures.2.
Pharmacists would also be protected from refusing to prescribe medicine, including the morning-after pill, if they opposed the prescription on moral grounds.

This bill does not violate the ability of a person seeking services to receive them from another source, but protects the conscientious medical decisions of professionals who object to particular services.

THE OBAMA ADMINISTRATION PLANS TO RESCIND THE 'CONSCIENCE RULE'.


At the end of February 2009, President Obama, furthering his support for abortion rights, announced plans to roll back the conscience rules, stoking battles between abortion and right-to-life supporters.

Dr. Suzanne T. Poppema, board chair of Physicians for Reproductive Choice and Health, praised Obama "for placing good health care above ideological demands."

However, Toni Perkins, president of the Family Research Council, said "Protecting the right of all health-care professional's judgments based on moral convictions and ethical standards...is necessary to ensure that access to health care is not diminished, which will occur if health-care workers are forced out of their jobs because of their ethical stances. President Obama's intention to change the language of these protections would result in the government becoming the conscience and not the individual." 3.

COMMENTS ARE INVITED AND ENCOURAGED THROUGH APRIL 9, 2009.

Advocates on both sides, medical groups and the public are invited to contact the Department of Health and Human Services to make comments on this proposal through the first week of April to express their opinions about changes in the conscience clauses.

HISTORY OF MEDICAL CONSCIENCE

The Hippocratic Oath, which pertains to the ethical practice of medicine, has traditionally been taken by physicians and continues to be a sacred document among health care professionals.

"I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give a woman a pessary to produce abortion"... (from the Hippocratic Oath)

Hippocrates was a celebrated Greek physician in the 4th century BCE. Even then physicians were organized into a guild with regulations for training and a professional ideal of practice.

"CHURCH AMENDMENTS"

In the 1970's, conscience provisions contained in the Department of Health and Human Services directives collectively known as the 'Church Amendments' (42 U.S.C.&300a-7) were enacted in response to whether or not the receipt of federal funds required recipients to perform sterilizations or abortions.

Conscience provisions provide that:

* the receipt of government funds does not require that individuals or entities be involved in sterilization or abortion procedures if it would be contrary to religious beliefs or moral convictions.

* Entities receiving funds (grants, contracts, loans), including biomedical research entities, are prohibited from discriminating against any physician or health care personnel who refused to perform a lawful sterilization or abortion procedure based on religious beliefs.

* Entities receiving funds are prohibited from discriminating against any applicant for training or study because of the applicant's reluctance to participate in counseling or assistance in abortions or sterilizations based on the applicant's religious beliefs or moral convictions.

CONCERNS ABOUT GOVERNMENT TAKEOVER OF MEDICINE


When freedom of conscience is overruled by directives from govenment or a governing board, totalitarian regimes may command citizens to engage in atrocious behaviors in opposition to their own feelings of appropriate behavior.

THE NAZIFICATION OF MEDICINE

A tragic example was seen in Nazi Germany, where doctors were used to commit unspeakable horrors under the direction of the state.

Physicians were identified as 'servants of the state'. Personal responsibility for decisions was taken away from individual doctors and nurses. 4.

The overarching Nazi biomedical vision involved medicalized killing, killing in the name of healing for the good of the 'Volk'. Sterilization, mercy killing, euthanasia and destroying 'life unworthy of life' were seen as responsible medical practices.

In a period of 7 years, the Nazi holocaust eradicated an estimated 21 million people, many of whom were killed by medical doctors who had no voice or choice but to obey the directives of the state or lose their license. Those killed included the handicapped, children, aged, sick, ethnic groups, conscientious objectors, and any critics who opposed the Nazi agenda. 5.

MEDICAL KILLING IN AMERICA

Since the enactment of Roe v. Wade in 1973, over 49,500,000 legal abortions have been performed in the United States. Since the legalization of abortion, the pressures not to abort have been replaced by a multitude of social pressures encouraging abortion. Increasingly, accounts of research studies related to abortion and stress report that in many cases the choice to abort was not made by the woman but was forced upon her by husbands, parents, doctors, counselors, or friends. 6.

In 1994, Oregon voters approved a bill permitting terminally ill patients with less than six months to live to request and self-administer lethal doses of medicine. On March 5,2009, Washington State became the second state to approve this initiative, called the Death With Dignity Act.

Opponents of the bill contend that 'assisted suicide' is a more accurate description of this legislation. Kenneth Stevens, a Portland, Oregon radiation oncolgist said assisted suicide "is a reversal of the historic role of physicians as healers, as comforters, as counselors." 7.

FREEDOM OF CONSCIENCE IS DEMOCRACY IN ACTION

The ability to act on personal and moral conscience is the foundation of our liberty and freedom. The right of individuals to speak up and act on the basis of their individual sense of moral rightness provides the checks and balances that protect us from the tyranny of totalitarian dictatorship.

The Obama administration is concerned that the Bush regulations could put in jeopardy family planning services and counseling for vaccines. The administration will review comments from the public before making a final decision.

Responsible citizenship requires that we speak out to make our concerns heard.


REFERENCES
1. Lewey, Noam. N. February 27, 2009."Obama administration may rescind 'conscience rule'.Washington Bureau. Chicagotribune.com.March 21, 2009.
2.Berger, Matthew. March 3, 2009. "Obama Plans to Rescind Healthcare 'Conscience Clause'. http://www.crosswalk.com/news/commentary/11600261. 3/21/2009.
3. Young, Saundra. March, 19, 2009. "White House set to reverse health care conscience clause'". CNN.com. Campbell Brown: No Bias. No Bull.
4.Lifton, Robert Jay. 2000. The Nazi Doctors: Medical Killing and the Psychology of Genocide. Basic Books
5. Rummel, R. J. 1992. Democide: Nazi Genocide and Mass Murder. New Brunswick,NJ: Transaction Pub. http://www.hawaii.edu/powerkills/NAZIS.CHAP1.HTM.
6. Basu, Alaka Malwade(ed.) 2003. The Sociocultural and Political Aspects of Abortion:Global Perspective.Chapter 14.The Social Pressure to Abort. Praeger Pub.
7. Allen, Marshall. August, 2004. "Death Wishes". Christianity Today. Vol.48, No.8,page 24.