Fema Employment

POLL: ARE YOU IN SUPPORT OF THE RIGHT OF CONSCIENCE RULE THAT WAS RECENTLY PASSED?

THIS IS LONG JUST BACKGROUND TO THE RULE Federal law has affirmed doctors' right to act according to the dictates of their conscience and protected providers who don't want to participate in abortions for more than 30 years. But still, anti-abortion advocates have been eager to see more far-reaching protections enacted. They got their wish on January 18th, when the outgoing Bush administration announced a new regulation that extends the "right of conscience" to a broader range of health care workers and activities. The 127-page rule will require as many as 584,000 health care facilities to certify in writing that they accomodate medical workers who refuse to provide services based on moral or religious beliefs, according to the Washington Post. SOME VIEWS OF PEOPLE Washington, D.C.: How wide-spread a problem is this issue? Are these cases of medical professionals refusing care or facing employment issues still relatively rare? Have there been any surveys of medical professionals to see how the larger community feels about these issues? Rob Stein: Unfortunately there is no good data on how frequently this occurs. A few surveys have been done though. One, of nurses, for example found a significant proportion said they had been in situations where they felt their personal beliefs were challenged. _______________________ Bethesda, Md.: Could you provide a little more background on the Chicago EMT story? I'm curious about the status of the woman who was awaiting transport. If her health status was serious enough to require an ambulance, then it sounds as if the EMT put the needs of the fetus above those of the woman. Could you please comment? Rob Stein: There isn't much information available about the patient. It was listed as an 'elective abortion,' implying that it was not an emergency situation. _______________________ Vienna, Va.: This country, for good reason, does not recognize a "right" to anything other that medically necessary treatment. Do you see the movement towards forcing medical personnel to provide unnecessary medical treatment as a greater fight for some type of inalienable right to premium health care? (I do.) Rob Stein: That's an interesting point. Some of the experts I interviewed for these stories pointed out that part of what's going on in this debate is the changing nature of the health care provider-patient relationship as patients have become more assertive. _______________________ Washington, D.C.: Has this 'right of conscience' been practiced as widely in the past or is this a relatively recent phenomenon given the current political climate? Rob Stein: It has been an issue for a long time. After the 1972 Roe vs Wade decision, for example, states began passing 'conscience' laws that specifically protected doctors and nurses who did not want to do the procedures. Nearly every state now has one of those on the books. It also came up when Oregon legalized physician-assisted suicide. That law too allows health care workers to opt out. _______________________ Silver Spring, Md.: I have HMO coverage so my choices of health providers is not always that wide. If I want something that someone decides goes against their ethical principles is my HMO obligated to provide me with that service if it is legal within my state? Rob Stein: There are some states that are considering new laws that would allow health care plans to NOT cover certain things.But if the care is currently covered by your plan it should continue to do so. _______________________ Arlington, Va.: As a student planning on attending medical school next fall, I find it appalling that medical professionals place their own moral agenda ahead of what is best for their patient. Religious objection to me is not a compelling reason for refusing service to someone. Why is the AMA and some states allowing this to happen? Rob Stein: The AMA hasn't directly addressed this issue directly, although its ethics guidelines do specify that physicians have an obligation to put patients concerns first. States are considering laws on both sides. _______________________ Maryland: It seems to me that prescribing and talking about birth control is a pretty important part of a gynecologists' job. I would imagine that any gyn. who declined to do this would quickly find himself without patients! I know I would leave, after I gave him a piece of my mind. The problem is that some women in more rural parts of the country may not have much choice in gynecologist. Why did these people become gynecologists if they have a fundamental problem with such a large part of the job? Rob Stein: Those with objections say they don't have any problem with most aspects of their jobs they have no problem doing. It's just certain aspects -- abortions, sterilizations, birth control -- where the conflicts arise. _______________________

Public Comments

1. Yes, this is one of Bush's few midnight policies that I actually agree with.
2. It depends on who you think is in a better position to determine the purpose of a doctor: the experts that advise the society who decides it needs to employ them in the first place, or the many each-one-is-different doctors themselves. Yes, doctors should be allowed to give their personal view too, and to opt out of procedures they have particular difficulties with, but they should also have to tell the service user what the official evidence-based recommendations are too.