"The Obama administration on Friday rescinded most of a 2008 rule that granted sweeping protections to health care providers who opposed abortion, sterilization and other medical procedures on religious or moral grounds. Kathleen Sebelius, the secretary of health and human services, said the rule, issued in the last days of the Bush administration, could 'negatively impact patient access to contraception and certain other medical services.'"
These are the words of the NY Times article detailing the Obama administration's latest action concerning the Bush Era conscience protection measures that finally gave teeth to the Church and Weldon amendments that specifically protected health care workers from being forced to assist or perform abortions. Previoulsy the commentary on the HHS regulations had read:
The ability of patients to access health-care services, including abortion and reproductive health services, is long established and is not changed in this rule. Instead, this rule implements federal laws protecting healthcare workers and institutions from being compelled to participate in, or from being discriminated against for refusal to participate in, health services or research activities that may violate their consciences, including abortion and sterilization, by entities that receive certain funding from the department. (It also implements the provisions of federal law which protect health-care personnel from being discriminated against for their participation in any lawful health service or research activity, including abortion and sterilization, by entities that receive certain funding from the department.)
This is quite contrary to the tune that Kathleen Sebelius, the current director of HHS is singing. The new rule will maintain an office for complaints to be filed, but given that the Obama administration has effectively ignored the the Bush Rule that was in place for the past 2 years, it is doubtful that this office will do much of anything when a nurse, student, or physician is pressured by an employer or school to assist or perform in an abortion. The Vanderbilt Case is a good example. More and more pressure is being applied to health care providers to simple 'go with the flow' and do whatever the patient desires in regard to abortion and contraception. We are losing our rights, and in losing our rights, the patient is losing theirs.
In 2009 I wrote a paper for the Linacre Quarterly entitled The Loss of a Physician's Freedom of Consicence will Result in the Breakdown of Patient Autonomy within the Doctor-Patient Relationship. In this article I wrote:
The doctor-patient relationship is founded upontrust. The patient must trust the doctor to keep confidentiality, to respect his autonomy, and to do the patient good. The doctor must trust that the patient is telling him the complete information and will follow the treatment plan. Without trust, effective health care is not going to occur. How does the conscience fit in with trust? Take, for example, an individual who is a Jehovah’s Witness. The patient is in a situation where the doctor is recommending a blood transfusion, but the doctor also knows that this individual will not take a blood transfusion because it would be a violation of their conscience. The patient must trust the doctor to respect their conscience and thus their autonomy. If the patient does not feel that a doctor would respect their autonomy, then an effective relationship will not be established and the patient will be in fear of what the doctor may do. However, one key way that a patient can know that a doctor will respect their conscience and autonomy is by seeing that the doctor respects and adheres to his own conscience. How could a patient trust a doctor to respect his own wishes if the doctor is willing to violate that very faculty that is supposed to help him recognize truth and act according to it? It would seem that most patients may have a difficult time fully trusting this doctor to act in their best interest. To brush these concerns aside is to ignore a reality of human nature and to put at risk the foundation of the principle of autonomy in medicine.
This step of the Obama Administration is another attack on not only health care providers, but also on patients themselves. The continuing erosion of the rights of the provider will only continue until the rights of the patient to make medical decisions for themselves has been eliminated as well. We must continue to fight for our right to practice medicine as our faith and our conscience directs us, it is the only way that the true Art of Medicine will be saved.
