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Medical conscience rule blends religion and medicine

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The controversial new Health and Human Services rule protecting the “conscience rights” of healthcare workers has some kick to it, namely the loss of government funding and associated legal costs if a provider doesn’t honor a workers’ right to practice their moral or religious beliefs on the job.

Providers are required under the new regulations to certify in writing that they're complying with federal laws protecting the conscience rights of healthcare workers to refuse to participate in or make referrals to services they find immoral. The rules are so vague that tangential staff such as receptionists and janitors, as well as institutional heads of hospitals, HMOs and insurance companies, are covered.

"This last-ditch effort to undermine women's health and privacy is a transparent payoff to the right-wing pressure groups,” said Nancy Keenan, president of NARAL Pro-Choice America. “We look forward to working with the incoming Obama administration to reverse this divisive rule and change the tone of the debate over reproductive rights by protecting women's access to contraception, which actually helps prevent unintended pregnancies." 

The 11th hour ruling by the Bush administration (the regulation takes effect on the eve of President-Elect Obama’s inauguration) was a surprise and a disappointment to many, but the development was long supported by a core group of Catholics, evangelicals -- and a subgroup of physicians.

Some small medical practices have already incorporated religion into their offices. The staff at the faith-based Tepeyac Family Center in Fairfax, VA, start each day with a prayer and is the “only known medical facility using the language of John Paul II’s Theology of the Body in their daily work,” according to its web site.   

Religious images adorn the office walls. Tepeyac doctors don’t prescribe birth control or sterilization or provide other devices or medicines or devices that go against their faith – but they do preach natural family planning and abstinence. Its Divine Mercy Care Pharmacy in Chantilly VA., (which opened in a strip mall on Oct. 21) was blessed by a Catholic bishop (photo) who said the pharmacy will work to convert people to the pro-life cause. Divine Mercy is one of a handful of U.S. pharmacies that do not sell any contraceptives, including condoms. 

While critics of the new trend in medicine say it deprives women of basic health care services, there’s a subgroup of physicians who feel so strongly against birth control that they will not even discuss these options with patients. 

A University of Chicago survey of 1,144 doctors, published in the NEJM in 2007, found that while a majority (86 percent) of doctors believe that they are obligated to present all treatment options, whether they approve of them or not; and 71 percent feel compelled to at least refer patients to another doctor for treatments they oppose; about 15 percent of the doctors surveyed said they had no obligation to present any option that violated their beliefs. 

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When a small private anti-abortion clinic touts its “pro-life” niche, people know going in what kind of care they’ll receive.  

But the new rule applies to federally funded health centers and the right to refuse service and make referrals is extended to all staff working within them. Clearly, the intent of the rule is to surreptitiously inhibit and undermine a patient’s ability to make informed decisions about their health care needs and access any and all legal services.   

Related:

Religion and Medicine A Bad Mix

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Kathlyn Stone is a Minnesota-based writer covering science and medicine, health care and related policies.-She publishes www.fleshandstone.net, a health and science news site.

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