Freedom of Conscience

On his show Tuesday night, Glenn Beck talked about a plan by the Obama administration to repeal the "Freedom of Conscience Act", which gives health care workers the option of refusing to participate in medical care they find objectionable.

Known formally as the "Provider Refusal Rule", sometimes referred to improperly as the "abortion rule", it went into effect January 20, 2009, the day Obama was sworn in as President of the United States. Much of the focus on this rule is with abortion, but the rule goes much farther, and applies to everyone applicable in the delivery of health care by setting up a rule wherein the health care institution may not:

Require any individual to perform or assist in the performance of any part of a health service program or research activity funded by the Department if such service or activity would be contrary to his religious beliefs or moral convictions.

— 45 CFR § 88.4(d)(1)

"Individual" is defined in 45 CFR §88.2 as "a member of the workforce of an entity/health care entity". Not just physicians and nurses. Any member of the workforce of the health care entity. And in case you’re wondering, "funded" includes reimbursements from Medicare and Medicaid.

Congresswoman Diana DeGette [D-CO(1)], one of the more vocal opponents to this rule, said "That rule was so broad that even the cashier at Walgreens could refuse to provide medication for somebody if the cashier decided they have a religious objection." Whether that is true is, as far as I know, yet to be seen.

The press correctly called this rule "far reaching" because it allows health care workers to legally refuse to "perform or assist in the performance of any part of a health service program or research activity", including, but not limited to, abortion.

Many States already have laws providing that pharmacists don’t have to fill prescriptions ("scrips") that violate their moral conscience. The language of the law was specifically aimed at the "morning after pill" and hormonal contraceptives, but it can be far more reaching than that.

My fiancée, I will confess, is on hormonal birth control, and we obtain those pills through Planned Parenthood. Why? Because we know that we will have no problem or issue getting those pills at a Planned Parenthood clinic. We won’t have to worry about some pharmacist having a "morality moment" and saying to us "No, I won’t fill that prescription because it violates my conscience."

It’s already happened numerous times — Google it.

But why would a pharmacist refuse to fill a birth control prescription? Hormonal birth control works in two parts. First, it tricks the body into thinking it is already pregnant, thus preventing an ovum, or unfertilized egg, from being released into the fallopian tubes. If the pill fails to prevent this and an egg is fertilized, the pill’s secondary purpose is to prevent the egg from implanting into the uterine wall.

Some pro-life pharmacists and physicians refer to that also as an abortion because even that fertilized egg is a baby in their minds.

Pretty soon, family planning clinics will be the only place you can have access to any birth control method except "pulling out". Hell, Planned Parenthood provides condoms for free — take as many as you want. And they have a shelf life of 5 years, so no worries there if you take an entire jar full.

And this refusal to fill scrips goes further than birth control and Plan B. Got a scrip for Viagra or Cialis? Pray your pharmacist doesn’t have a "morality moment". ADHD medication? Yep, allegedly pharmacists have refused to fill those scrips as well.

Prescriptions are medical orders. As such, unless the pharmacist has a medical reason, the pharmacist should not have the legal ability to refuse to fill that scrip. Medical reason could include several things, such as a conflict with another medication currently on file for that patient. But moral objections are not medical reasons.

And now the Obama administration wants to scale down this rule, and pro-lifers are screaming. "How dare they force doctors to perform abortions?"

Better yet, the question should be: how dare the Bush administration allow so many people along the chain of care to refuse to provide their portion of the chain of care because of their "morality"? And I’m not talking about doctors and nurses, and not even just pharmacists (though they’ve gotten much of the press).

What about obstetricians refusing to perform pap smears on unmarried women? Catholic physicians refusing to correct an ectopic pregnancy, a medical emergency, since the only correction is to terminate it? Worse still, what if these doctors refuse to provide a referral or bring in another physician for fear of appearing complicit?

I’m not talking about patients refusing care or opting for "complementary or alternative medicine", but physicians or nurses refusing to provide care and pharmacists refusing to fill scrips purely based on "morals", and this is happening worldwide.

Does no one see the issue with this?

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