Okay, try this …
I am going to force you to do something — something you consider immoral, abetting behavior you consider immoral, something that violates your conscience, your religion, your holy vows. I am going to force you to do it. If you don’t, I’m going to ruin your livelihood, your business, and I’m going to sue you for every last penny you own. You have no choice. No choice at all.
And, on the other hand …
I don’t like you. I don’t approve of you, or of what you do, or why you do it. So you know what? To hell with you. I’m not going to help you. I don’t care if it makes you suffer. I don’t care if it hurts you. I don’t care if it’s my job to help you. I just don’t care for trash like you and your kind. Get out of here.
Michigan’s legislature is in the process of passing the “Conscientious Objector Policy Act” and related legislation. It shields health-care workers and insurance companies from firing or law suits if they refuse to perform a medical procedure, fill a prescription or cover treatment for something they object to for moral, ethical or religious reasons.
In most of the debate on the matter, the focus is on abortions and emergency (morning-after) contraceptive services. But as this article notes, it could also give someone an out to turn away someone from (non-emergency) medical care just because they’re, say, gay. While there is evidently a provision in the bill to prevent discrmination based on race, deciding that homosexuals are abominations before the Lord, and therefore can be refused treatment or insurance coverage would evidently be perfectly legal.
Yeesh.
And yet, by the same token, should a Catholic pharmacist who believes that abortion is a sin be compelled to sell someone morning-after contraception? I’m not sure I’m willing to say yes — but I’m also not sure I’m willing to have someone be unable to get such a (legal) prescription because of it.
(Oddly enough, ordinary contraception is excepted by the bill, which seems to fly in the face of its basic principles.)
In other words, the ostensible principles (never mind for a moment anything about ulterior motives) behind the bills seem sound, but their application is troubling.
Republican state Rep. Randy Richardville of Monroe, who introduced the main bill of the package, said the legislation is intended to protect religious, moral and ethical freedoms of health-care providers. “Nothing in this bill, not a thing, denies a patient from receiving medical care,” he said. “This simply means a medical professional cannot violate their religious obligations.”
Paul A. Long, vice president for public policy for the Michigan Catholic Conference, said the bills promoted the constitutional right to religious freedom.
“Individual and institutional health-care providers can and should maintain their mission and their services without compromising faith-based teaching,” he said in a written statement.
But the odd set of exceptions — the two noted above, race (can’t folks be bigotted for religious reasons?) and birth control (which, last I checked, was also against Catholic doctrine) — make this a bit less than a pure First Amendment defense. And the breadth of what discrimination could be allowed, and the pain and suffering that could stem from that (even if emergency services cannot be denied), seems a dangerous path to take.
And that doesn’t even get into what constitutes a “legitimate” religious objection, something I’m as loath to let the courts decide as I’m sure they are — but which I’ll be damned (so to speak) if I’m to let someone claim it as a rationale for whatever they do or don’t want to do.
If the specific, openly-debated matters of conscience were themselves the only target of the bill, I might see it as a reasonable compromise between religious convictions (even ones I don’t share) and the public good. I wouldn’t be happy about it, but unhappiness is usually part of compromise. But by turning it around and making it about everything except a few sacred cows, it seems to open the door far too wide to let individual — and institutional — discrimination prevail.
(via Scott)
UPDATE: Subject revisited.
What if the religious objection is that the patient isn’t the same religion as the doctor? After all, there are belief systems out there whose tenets include things along the lines of, (I’m paraphrasing here) “Let the infidels die.”
Indeed.
And even though emergency care is supposedly excepted, the distinction as to what constitutes that can get kind of fuzzy.
On the other hand (to use an argument I used elsewhere), what if there were a medical procedure that I actually strongly objected to — female genital mutilation, for example — that somehow was legal. (After all, “legal” and “good” or “wise” or “agreeable” are not synonyms). Would I feel as quick to tell a doctor that, under penalty of loss of license, civil suit, whatever, they should be compelled to perform such a procedure? Or tell an insurance company or medical firm that they had a legal obligation to pay for such things, regardless of their beliefs about it?
At the risk of violating Godwin’s Law, if a doctor in Nazi Germany decided to eschew a command to perform experiments on a human being because to do so was morally repugnant, would I support such an action? Would I feel the state and society had the right to compel their action?
I thought that medical folk to oaths and such.
You know…oh, well.
I know we had this in Colorado last session, and I’m fairly sure that it made it through the House, but was blocked in the Senate. I don’t think it came up this year. I’ll have to do some looking up to see if it is law or not. Or Margie may know.
This same law passed in Mississippi last month.
Alas, “do no harm” cuts both ways (so to speak). I could argue (whether I agree with it or not) that providing abortion or morning-after birth control services is causing harm to a human being. I could argue that providing medical care to gays harms people (I’d rather not sully my brainpaths coming up with the argument, but I suspect it could be done).
And that same subjectivity also allows some folks to argue that doctor-assisted suicide is moral and within the Hippocratic Oath. YMMV.
But while the Hippocratic Oath (does that apply to pharmacists and insurance companies?) is a swell sentiment, I’m not sure it has the force of law, nor should that it should be.
I wish I had an easy answer for this one, but I can see (and make) very compelling arguments and meta-arguments on both sides of it.
I think this is a problem because it involves a conflict between two fundamental values that we hold dearly: freedom and equality. The doctor’s freedom is infringed when we force him or her to perform medical procedures he or she objects to. The patient’s equal rights are violated when a doctor refuses to treat them on the grounds that they are gay or black or jewish, or whatever. I don’t see any way to promote one of these values over the other since they are both fundamental, so I suspect this is a conflict that will be with us for a very very long time.
At the same time, it is disingenuous to say that the Michigan law won’t prevent anyone from getting medical care. It will if all the doctors in town share the same view of the medical procedure you need, or if public opinion pressures them to act as if they share that view. This will be a particular problem in one-doctor towns, or if people are able to coerce doctors into following their beliefs as some parts of the anti-abortion movement tried to do with their death threats against doctors who performed abortion.
My view is that doctors and hospitals who receive government funding should not be allowed to refuse to perform a procedure on religious grounds, but doctors who do not accept government funding should not be forced to perform a procedure that is contrary to their religious beliefs. This is not ideal, but at least it would be clear that the government was not supporting discrimination on religious grounds.
>>Dave
Well said, Dave, and nicely clarified.
As to your solution — I don’t know enough about the med biz, but I’m not sure whether there are any doctor or hospitals who don’t receive “government funding” of some sort, e.g., Medicare, Medicaid. Whether it’s on the public insurance side of things, or government-funded research, or whatever, the government’s dollars extend a long way. But it might be something to look at.
On the other hand, while it’s good to say that the government doesn’t support discrimination, I’m not sure it’s good to say that the government doesn’t allow freedom of conscience.
Too bad we can’t change it to a sort of a paraphrased “Hard Rock Cafe” oath.
Care for all, Treat all
Yes, arguments can be made for all of the differing points of view. Maybe we need to grant religion the same level of “protection” that sexual preference and abortions are granted, since they are all just choices.
BTW, there are many oaths that doctors take, not all of which have their origin in the Hippocratic Oath. They can be quite different in content, and there is a fairly wide lattitude for interpretation (see http://www.imagerynet.com/hippo.ama.html).
The classic Hippocratic Oath includes a clause that says a doctor promises to teach medicine to the children of his teacher for free, and also rules out abortion and sexual relations with patients and their kin (see http://www.pbs.org/wgbh/nova/doctors/oath_classical.html).
Another version is explicitly for Christian Doctors (see http://www1.umn.edu/phrm/oaths/oath3.html).
There’s a doctor’s oath specifically for Muslims too, but it isn’t obvious to me that it comes from the Hippocratic Oath (see http://www.islam-usa.com/im2.html#the).
Yale Medical School formulated their own doctor’s oath, and Harvard Medical School allowed each class to write their own (see http://www.yale.edu/lt/archives/v7n2/v7n2medicalschool.htm).
I’m sure that there are many others, but I wasn’t able to find a site listing more than one. A few sites give the classic version and a modernized version, but that’s it.
>>Dave