New Laws Protect Health Care Workers

Advanced Placement Students: Read the following article. Consider the ideas of Henry David Thoreau and Ralph Waldo Emerson. How do you think those transcendentalists would react to the following law?

New Rule Protects Health Care Workers' 'Right of Conscience'

By Rob Stein
Washington Post Staff Writer
Thursday, December 18, 2008; 11:08 AM

The Bush administration today issued a sweeping new regulation that protects a broad range of health care workers -- from doctors to janitors -- who refuse to participate in providing services that they believe violates their personal, moral or religious beliefs.

The controversial rule empowers federal health officials to cut off federal funding for any state or local government, hospital, clinic, health plan, doctors' office or other entity if they do not accommodate employees who exercise their "right of conscience." It would apply to more than 584,000 health care facilities.

"Doctors and other health care providers should not be forced to choose between good professional standing and violating their conscience," Health and Human Services Secretary Mike Leavitt said in a statement.

The regulation, which was issued just in time to take effect in the 30 days before the change of administrations, was sought by conservative groups, abortion opponents and others as necessary to safeguard workers from being fired, disciplined or penalized in other ways.

Women's health advocates, family planning proponents, abortion rights activists, members of Congress and others condemned the regulation, saying it would create major obstacles to a variety of health services, including abortion, family planning, end-of-life care and possibly a wide range of scientific research.

The 127-page rule is the latest in a flurry of federal regulations that the administration is implementing before President Bush's term ends, including a number that would weaken government protections for consumers and the environment.

Although the Obama administration could reverse the rule, it would require a lengthy process. Last month, however, Sens. Hillary Clinton (D-N.Y.) and Patty Murray (D-Wash.) introduced a bill to repeal the regulation legislatively.

In response to criticism that the original version of the rule was too broad, the final rule clarifies that it does not apply to entities that are unlikely to use federal for health services or research, such as programs that provide financial assistance for home heating for low-income families. But the rule continues to cover a broad array of workers, including support staff, trainees and even volunteers.

"Many health care providers routinely face pressure to change their medical practice -- often in direct opposition to their personal convictions," said Assistant Secretary of Health Joxel Garcia. "During my practice as an OB-GYN, I witnessed this first-hand. Health care providers shouldn't have to check their consciences at the hospital door. Fortunately, Congress enacted several laws to that end, but too many are unaware these protections exist."

The rule will go into effect in 30 days and gives entities until Oct. 1, 2009 to provide written certification of their compliance. Those that do not comply face having their funding cut off or being required to return funding they already received.

The proposed regulation prompted a flood of comments. Twenty-eight senators, more than 110 House members and more than a dozen state attorneys general have voiced opposition, along with a variety of major medical organizations, including the American Medical Association, American College of Obstetricians and Gynecologists and the American Hospital Association. Three officials at the Equal Employment Opportunity Council (EEOC), which is charged with protecting workers' rights, have said the rule duplicates existing protections of religious freedom.

The rule is supported by a variety of conservative groups, including the U.S. Conference of Catholic Bishops, the Catholic Health Association, which represents Catholic hospitals, the Christian Medical Association and the Family Research Council.

"This is a huge victory for religious freedom and the First Amendment," said Tony Perkins of the Family Research Council, a socially conservative group that opposes abortion. "No one should be forced to have an abortion, and no one should be forced to be an abortionist. These regulations will ensure that conscience protection statutes will be strongly enforced by the government in the same manner as our other civil rights laws."

The language of the rule, which will cost more than $44 million to implement, stressed that it is primarily aimed at making sure that federal laws on the books since the 1970s are enforced and that nothing in the regulation would prevent any organization from providing any type of care.

"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," it states. "Instead, this rule implements federal laws protecting health care 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 . . . "

Leavitt has said the regulation was intended to protect workers who object to abortion, both supporters and critics said the rule remains broad enough to protect pharmacists, doctors, nurses and others who do not wish to dispense birth control pills, Plan B emergency contraceptives and other forms of contraception. While primarily aimed at doctors and nurses, it offers protection to anyone -- including ultrasound technicians, nurses aides, secretaries and even janitors who have any role in the service.

Leavitt said he requested the new regulation after becoming alarmed by reports that health-care workers were being pressured to perform duties they found repugnant. He cited moves by two professional organizations of obstetricians and gynecologists that, he said, might require doctors who object to abortion to refer patients to other physicians who would provide them.

"The Department is concerned about the development of an environment in sectors of the health care field that is intolerant of individual objections to abortion or other individual religious beliefs or moral convictions," the rule states. "Such developments may discourage individuals from entering health care professions. Such developments may also promote the mistaken belief that rights of conscience and self-determination extend to all persons, except health care providers."

The rule comes at a time of increasingly frequent reports of conflicts between health care workers asserting their religious freedom and patients seeking legal treatments that some providers object to. Pharmacists have turned away women seeking birth control and morning-after pills. Infertility doctors have refused to help unmarried and lesbian women get pregnant by artificial insemination. Catholic hospitals have refused to administer the morning-after emergency contraception pill, perform abortions or treat women having miscarriages.

Experts predict the issues could escalate sharply if a broad array of therapies begin to become available using embryonic stem cells, which are controversial because they are obtained by destroying very early embryos. The Obama administration is poised to lift the Bush administration's restrictions on federal funding of embryonic stem cell research.

The rule's wording dismisses criticisms that it would apply to too many types of workers, stating that federal laws on the books are clearly aimed at protecting health facility workers beyond doctors and nurses.

"These laws are intended to protect the conscience rights of all individuals participating in health care services, and research programs," it states.

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