Monday, April 26, 2004

Updates Regarding the Conscientious Objector Policy Act
Wisconsin Tries the Same Stunt

As noted  on CC recently, the Michigan House recently passed a package of bills that would allow health care professionals, hospitals, and insurance companies to refuse to participate in any health care practice that they found to be morally objectionable.  I noted that there were few comments in the blogosphere or the news media that were supportive of this legislation.  My last post got a couple of comments, both expressing opposition to the legislation.  Today, I went out trying to find somebody  who actually thinks it is a good idea. 

I found that the Wisconsin State Congress recently sent a similar bill to their Governor, who promptly vetoed it.  A Catholic law blog then retracted its support for the bill. 

OK, first about the Michigan legislation: On Catholic World News, there is an article about the legislation.  While there is no overt editorial commentary, positive or negative, the selection of quotes in the article indicates that the author generally supports the legislation:

The sponsor of the primary bill, Republican Rep. Randy Richardville, in response to criticism from Democrat representatives that the bill would restrict patients' rights, said: "Nothing in this bill, not a thing, denies a patient from receiving medical care. This simply means a medical professional cannot violate their religious obligations."

Paul A. Long, vice president for public policy for the Michigan Catholic Conference, applauded the move. "Individual and institutional health-care providers can and should maintain their mission and their services without compromising faith-based teaching," his written statement said.

A medical blog that I missed the first time around, Gross Anatomy, makes no bones  about their opposition  to the legislation:

It's a frightening precedent they're trying to set--that you should be able to pick your patients, that it's okay to pass judgment on them when they walk in the door. The consequences could be dire for rural residents, since many times there are no other doctors available.

The Lansing State Journal has an editorial  on the subject (and a follow-up, which is here):

Published March 28, 2004
Health morality: 'Objector' bills deserve defeat

If you walk into a doctor's office or a hospital, do you want the people there focused on your physical condition, or your moral worthiness as a patient?

Under a package of bills backed by a group of legislative Republicans, a citizen's morality could become a legal reason to refuse medical care.

This "Conscientious Objector Policy Act" would allow health workers to shun you in non-lifethreatening situations, if your care conflicted with their "sincerely held religious or moral beliefs." [...]

The state, for secular reasons, issues medical licenses. No citizen or hospital or insurer has an absolute constitutional right to such licenses. If we did, anyone could claim to be a doctor and be so licensed.

People do have an absolute constitutional right to their religious views. Government cannot deny them. Neither, though, can government enforce those views on others.

Yet that is just what this legislation would do. Medical professionals would use their morality as a test for your care. A doctor or pharmacist could put up a sign saying "Sinners not accepted."

If protecting the health of others somehow conflicts with a person's morals, we suggest a simple solution: Don't practice medicine in Michigan.

Published April 23, 2004
'Objector' bills: Dangerous legislation inflicts moral judgments on patients

[...] The state Senate should reject the bills. If it doesn't, Gov. Jennifer Granholm should veto them. If she won't, the law should be challenged in court.

[...]  A law that broadly allows these professionals an escape clause because of moral misgivings is bad law. House Bills 5006 and 5276-5278 would be bad law.

The blog Kevindonahue.com, written by a person who describes himself as "a straight, married, 30-something, Texas Republican from the middle class," expresses  disapproval as follows:

Now, Some overzealous Republicans and Catholic priests decided this would be a good way for doctors to refuse to treat gay patients. That's crap. If you're a doctor (or an EMT, ER nurse, surgeon, etc) then you signed on to treat people in need. Race shouldn't matter, economics shouldn't matter, homosexuality shouldn't matter. Period.

What's with this "conscientious objector" nonsense? If a doctor things it's morally wrong to sell crack, then they don't have to treat drug dealers? If an EMT things it's wrong to be gay, then they don't have to answer ambulance calls to a gay person's home? If a nurse is atheist, can he refuse to take a blood test from a Christian?

A moral decision is definitely needed - but treating a patient cannot be the question. Doctors, nurses, and the like must ask themselves: Am I able to be a medical professional, or do I bear too much hatred to help someone in need?

Interestingly, I found that similar legislation in Wisconsin, Assembly Bill 67, was just vetoed  by their Governor:

Wednesday, April 21, 2004
Jessica Erickson, Governor's Office, 608-261-2156

Governor Doyle Vetoes Assembly Bill 67
Legislation Would Have Allowed Medical Professionals to Deny Care to a Patient Based on the Medical Professional's Own Ideological Beliefs

At the State Capitol today, Governor Jim Doyle vetoed a bill that would have allowed medical professionals to deny care to patients based on the medical professional's own ideological beliefs.

"One of the most sacred principles of our medical care system is that a doctor should always do what's in the best interests of a patient's health," Governor Doyle said. "Medical decisions should be made by patients and their doctors based on the best information and treatments that medical science has to offer. And physicians should provide complete and clear information in order for a patient to make the best possible health care decisions." [...]

"This legislation should be called the ‘Unconscionable Clause’ bill, because it would be unconscionable to deny our citizens the full range of needed medical treatment in order to satisfy the ideological views of some health care professionals," Governor Doyle said. "It is a disservice to patients and to our health care system, and today, I am pleased to stand with doctors, medical professionals, patients, and legislators, and veto this bill." 
For some reason, the Michigan legislation was reported and commented upon widely; Bloglines and Dogpile find few references to the Wisconsin legislation.  A group blog I had not known about previously, Mirror of Justice (tagline: A blog dedicated to the development of Catholic legal theory.), posted  the following:

April 25, 2004
Physicians in Wisconsin: a moral power play?

In response to my post on the Wisconsin governor's promised veto of the new state "conscience clause" (see "An amoral vision of physicians," below), a Mirror of Justice reader emailed me to point out that the statute seems not simply to excuse physicians from actively participating in certain procedures, but also from providing information on certain procedures.

[...]  it appears that my blanket endorsement of the statute may have been premature. One relevant section of the bill provides that "a hospital or employee of a hospital is immune from liability for any damage caused by a refusal to participate in [a range of activities, including abortion, sterilization, embryo research, fetal tissue transplants, withholding of nutrition/hydration, and euthanasia] if the refusal is based on religious or moral precepts." Significantly, "participate in" is defined very broadly: "to perform, assist in, recommend, counsel in favor of, make referrals for, prescribe, dispense, or administer drugs for, or otherwise promote, encourage, or aid."

[...] At a minimum, the statute does not appear to set forth (or preserve) any obligation to inform, as opposed to promote. If a woman's life is threatened by the continuation of her pregnancy, it should at least (in my view) be brought to her attention that abortion is an alternative, even if, for the physician, it is not an alternative in which he or she could participate in good conscience. Other parts of the statute state that a physician's moral or religious objection must be made in writing, which presumably gives the patient notice that the physician, as a general proposition, will not perform the procedure in question. But it is unlikely that a blanket notice will tell the patient much about abortion's potential relevance to the circumstances of her particular case.

Perhaps I'm misreading the statute. (If so, I'd welcome some enlightenment from a reader or co-blogger.) As I've indicated several times on this weblog, I am an unflagging supporter of allowing professionals to integrate their own moral and religious values with their provision of public goods. But I still believe that consumers must be empowered to make the ultimate decision about their own health care (or legal services, education, etc.) -- they just shouldn't be empowered to force a particular professional to facilitate it, especially when it embodies a morally objectionable vision of the good. But if Wisconsin means to allow physicians to avoid even making information about morally contested (but medically prudent) procedures available to the patient, the statute gives me pause. It's one thing to reinject a robust concept of moral agency into the physician's role; it's quite another to give the physician a statutory trump over the patient's own moral agency.

Posted by Rob Vischer on April 25, 2004 at 07:09 PM

The Mirror of Justice post includes a detailed comment by a reader, which is what prompted the author, Rob Vischer, to issue his partial retraction of support.  In my last post on the Conscientious Objector Policy Act, I pointed out that I disagreed with a statement on another blog: "Catholics hate all sorts of people."  Persons who agree with the comment are encouraged to read Mirror of Justice.  I found only thoughtful social commentary; no hate speech.  For example:

Earth Day

The recent observance of Earth Day prompts me to ask my fellow bloggers and any readers to recommend sources (legal or otherwise) engaging questions of stewardship of our environmental resources from a Catholic perspective.

Posted by Michael Scaperlanda on April 23, 2004 at 05:10 AM

A Burkean Function for CST in the Face of Ethical Pluralism

[...]  Catholic social teaching thus serves as one of the repositories of tradition by which we can evaluate value disagreements grounded on human reason. Individual reason in today's moral climate too often leads to mere values, which are purely matters of personal preference, lacking the moral force to bind others. In contrast, tradition emphasizes standards grounded on preferences that have been widely accepted over a very long period.

If I'm right about all this, it has important implications for those of us who bring to bear our own reason on the teachings of the Church. The function of human reason within a moral tradition is not a critical one, seeking to expose the tradition's faults, but rather a respectful one, seeking to learn what the tradition offers. [...]

Posted by Steve Bainbridge on April 25, 2004 at 03:14 PM

Perhaps the supporters of the Michigan Conscientious Objector Policy Act should read Mirror of Justice too.