SONICFROG DOT NET

A New Executive Order – "Right To Conscience". UPDATE

*This was originally written on Dec 8, 2008.*

When should the rights of the patient to get valid legal medical treatment be trumped by the conscience of the doctor? This is the question of the day.

Soon to be Ex – President Bush is poised to issue an executive order called “The Right To Conscience”. In a nutshell, it would allow doctors, nurses, and other health care providers to deny patients legal treatments such as artificial insemination and birth control, according to the moral beliefs of the health practitioner.

Dr. David  Stevens, president of the Christian Medical Association states:

“The real battle line is the morning-after pill. This prevents the embryo from implanting. This involves moral complicity. Doctors should not be required to dispense a medication they have a moral objection to.”

Another change – For thirty years, legally doctors have had the option not to perform abortions, but they were required to tell the patient where they could get the wanted procedure. Under this order, that will no longer be required.

I have many problems with this change in law.

This order sets a potentially dangerous precedent. The old law was very concise and easy to follow. But now, if this comes to pass,  we would see an erosion in the concept of standardized treatment. Who gets to define what is acceptable when denying treatment due to “Conscience”. The current debate is driven mainly by  Christian opposition  to abortion, and by extension, to birth control of any kind. What of other religions? If we are going to respect the moral rights of Christian doctors, shouldn’t we also respect the conscientious rights of others in the medical profession, outside the preview of birth control. Why should doctors who feel strongly that homosexuality is a sin be required to give HIV medication to homosexuals. It was their sin that caused the disease. And why should white Christians have special rights. Orthodox Muslim doctors should be able to turn away Jews or other non-Muslims because they are not human according to their conscience? And before you say that there aren’t any radical Muslims who are doctors, I would have you read “The Loomeing Tower” (Ayman al-Zawahiri, a name you might recognize, was a trained surgeon).

What if I go to the doctor to get one of these procedures, and the doctor says no, based on his moral beliefs. I have just lost a days wages to make this visit, and now I have to take even more time to search out another doctor, since this one will not even tell me where I can go for treatment. As I was denied a legal service, I would expect to have the right not to pay this doctor for not providing it, not based on a medical rational, but on his or her religious beliefs.

My biggest problem with this is the use of executive order to alter the medical landscape. What ever happened to the legislative process? I am not fond of radical changes in law via court mandate, such as gay marriage. I call both types of changes sub-constitutional. They are not in the Constitution, but are recognized a necessary in order to govern. Executive orders are general reserved for big, overarching issues. Jefferson used it for the Louisiana Purchase. Lincoln used it as a vehicle for the Emancipation Proclamation. Both lofty and vital to the health and growth of the nation. The “Right Of Conscience” seems to me not to fall into that category. Will the opponents of court mandated changes in marriage laws that allowed gay marriage, now rail against this monarchical move by the President to change this standard? At least when judges change law, it has been the result of legal debate and can be argued against during the process. By changing this via Executive order, Bush will have bypassed any legal due process or public debate, and changed the law by waving the Presidential magic wand. King George Survives!

Though I do recognize the moral issues in this debate, ultimately the rights of the patient trump the morals of the doctor. If the procedure is recognized as legal, the patient should be able to rely on the doctor to either perform the procedure, or, if he or she does not want to do it, direct the patient to a doctor who does.

Yeah, it sucks for the doctor if they feel that strongly about it. But if you don’t like it, find a different profession.

UPDATE: No surprise, on Dec 18th, the Bush administration has approved the regulatory change.