December 2, 2008

Why Should Their Moral Rights Be Trampled?

Justin Katz

The Bush administration is entirely right to permit healthcare providers to refuse tasks that they find objectionable:

The outgoing Bush administration is planning to announce a broad new "right of conscience" rule permitting medical facilities, doctors, nurses, pharmacists and other healthcare workers to refuse to participate in any procedure they find morally objectionable, including abortion and possibly even artificial insemination and birth control. ...

Health and Human Services Department officials said the rule would apply to "any entity" that receives federal funds. It estimated 584,000 entities could be covered, including 4,800 hospitals, 234,000 doctor's offices and 58,000 pharmacies.

If private organizations wish to require particular procedures to be done, that's within their purview, but the government's position should be in line with the rights and freedoms that it guarantees to its citizens.

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As long as their employers are within their rights to give those who refuse to treat the opportunity to find more appealing vocations I'm all for it.

Posted by: Greg at December 2, 2008 2:28 PM

I’m with Greg on this.

If you support physicians choosing to not provide a legal prescription for birth control based on their ‘conscience’, would you also support a physician who chose to provide an unproven experimental treatment? (think Dr. House) Can they refuse to treat a homosexual? Can a physician refuse to abide by a patient requested DNR? What about a physician who refused to treat a soldier based on his view of the war or the way he got injured (i.e.: self-inflicted) In other words, how much leeway does a physician have based on his or her conscience or moral views?

If a physician chooses not to perform certain procedures, administer certain rx or deal with certain situations, then he has the right to find an employer who will agree to that. But I think the physician should be required to be upfront about his or her moral views that affect care. I am against the right of physicians to deny a patient a legal treatment (including elective) without any consequence. And the employer should have the same right to make decisions based on their conscience.

Posted by: msteven at December 2, 2008 4:33 PM

That's fine, as long as there's someone else down the street that offers the procedure.
If there isn't, we have a problem.

Posted by: rhody at December 2, 2008 4:40 PM


I think you make some categorical errors in your construction of rhetorical equivalents.

There is a difference between refusing to perform an objectionable procedure (or prescribe an objectionable drug) and:

1. Insisting on performing an illicit procedure.
2. Refusing to treat an objectionable person (whether out of bigotry or protest).
3. Insisting on performing a procedure against the patient's will.

Just as the public has the right to attach anti-discrimination strings to its money, it has the right to (and should) attach a string that ensures that its money does not go toward forcing doctors and supporting personnel to perform procedures that they find morally repugnant. Of course, I agree that the employer should be free to hire (but not fire) fully informed about employees beliefs and their effect on his or her work.

I'd never suggest that an individual upholding moral standards ought to be guaranteed that their resolve ought to be made free of consequences.

Posted by: Justin Katz at December 2, 2008 8:25 PM

So, under this rule does a doctor who refuses to treat military veterans on the grounds that the doctor feels they have willing participated in violations of God's Commandments also get a pass?

Just curious.

Posted by: Thomas Schmeling at December 2, 2008 11:32 PM

oops. I pulled the trigger too fast. I now see that my concerns were already expressed in the comments, and Justin already answered regarding the "categorical errors in your construction of rhetorical equivalents."

Justin says,

There is a difference between refusing to perform an objectionable procedure (or prescribe an objectionable drug) and:Refusing to treat an objectionable person (whether out of bigotry or protest).

The question is, "why"?

Posted by: Thomas Schmeling at December 3, 2008 12:05 AM

You need me to describe the difference between a person's refused performance directly of an act that he finds repugnant and a person's refusal to help somebody out of judgment against him personally?

Is it just as wrong not to give a man food based on the color of his skin as it is to decline to give another man pornography?

Posted by: Justin Katz at December 3, 2008 5:29 AM

Maybe the pharmacist find homosexuality 'repugnant'. Or maybe mixed marriage. Or maybe they find old people having sex a 'repugnant' act.

What about when the pharmacist refuses to give the abortion pill to a woman who was raped? When that woman's family inevitably (and rightly) sues the pharmacy chain for the humiliation she was put through at the pickup counter will they vehemently defend the pharmacist or kick him/her to the curb?

I know my response if the pharmacist refused to give me a drug my doctor prescribed based solely on their religious beliefs. I'll simply advise them to fill the bottle or they can discuss it with their 'god' directly when I beat them to death with the iron I grabbed from the housewares aisle.

Posted by: Greg at December 3, 2008 7:40 AM

For a physician, I think it is reasonable for them to inform their employer and patients about how their moral beliefs may affect their care – such as in the case of abortions, fertility and prescribing birth control. But if the doc does not disclose this and it is not identified until the situation is encountered, I think that is fraudulent on their part and cause for termination.

In the case of a pharmacist who refused to fill certain Rx they find objectionable, that does not seem reasonable in a retail environment. If the pharmacy hires knowing what they will not fill and make accommodations, then OK. But it seems to me that customers have a reasonable right to expect their pharmacist to fill legal Rx prescribed by their doctor. And refusing to do that means that their religious or moral beliefs are getting in the way of doing the job for which they were hired. Pharmacists with such views have choices to pursue employment in other areas such as research. To me, it is no different than someone who refuses to sell alcohol based on their moral views working at the checkout at a grocery store.

Posted by: msteven at December 3, 2008 12:38 PM


... refusing to do that means that their religious or moral beliefs are getting in the way of doing the job for which they were hired.

Not if they are self employed or their employers agree with them. Then the only sense in which they are not doing the job that's expected of them is if we see the customer as supplying the job. The customer, in that case, has a right to shop elsewhere.

Posted by: Justin Katz at December 3, 2008 8:00 PM

Agreed - if they are self-employed or have the support of their employer, then they have the right to do what they want (you know what I mean)

But what about the issue of someone whose job it was to grant marriage licenses in Massachusets. Do they have the right to not provide them to gay couples based on their moral views? I think the scenario did come up and recall that the people in question were given other govt jobs. But that doesn't deal with the real issue ... probably one for SCOTUS to decide :)

Posted by: msteven at December 3, 2008 9:05 PM
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