Tuesday, December 22, 2009

Conscience Protection Key for Health Care Reform

Conscience protection is a key issue in health care reform. The bishops want protection for Catholic and other institutions, especially health care institutions, so they can to be true to their vision, and for all health care personnel so they can be true to their conscience.

Today we often see the rights of institutions challenged. The most obvious concern is the right of hospitals not to perform abortions. The Weldon Amendment, a rider to the annual Health and Human Services funding bill, protects hospitals that do not provide, refer for or pay for abortions. Yet even with its existence this right of conscience is threatened when pro-abortion groups organize campaigns against hospital mergers in which a Catholic hospital assumes responsibility for a struggling hospital that is not Catholic. Some groups fight such mergers unless the “right” to an abortion can be guaranteed there or close by. Sometimes, they make mergers fall through, sad proof that some would rather risk seeing all health care denied, from heart catheterizations to hip replacements to cancer treatment, in order to keep abortion in the neighborhood.

Any health care reform bill needs to have conscience protections for institutions that provide and purchase health care. The Catholic Church, with more than 600 health care institutions serving millions annually, is a major health care provider in the United States. The quality of care in these facilities is proven time and time again. Conscience protection for them benefits not just Catholic hospitals, but the nation’s entire health care system and the patients it serves.

Conscience protection for individuals also needs to be guaranteed. Wherever they work, those who find abortion morally repugnant should not have to participate in it. You don’t have to be a moral theologian to feel abortion is wrong. Some things are instinctive, and some are enshrined in the Hippocratic Oath that has shaped the idea of medicine as a healing profession. No medical personnel should be forced to take another human being’s life.

Today it can be hard to stand up against peers and supervisors; if an individual feels his or her job is on the line, the pressure can be enormous. A case in point: In Ohio, last September 15, according to an Associated Press news report, Dr. Carmelita Bautista was pressed into service by a prison execution team to help find a vein so a lethal injection could be administered. This is something medical ethicists frown upon and the American Medical Association bans. Despite this, Dr. Bautista apparently felt she had to agree to the casual request. Apparently she felt uneasy, noting later that she’d never done anything like that because, she said, “we are supposed to help people who are sick.” Nevertheless, she did what she was asked and tried - unsuccessfully - to help. It was a casual request, to just find a vein, and she wasn’t sure she was really assisting at an execution, but as she drew closer to the death house she felt frightened.

Who else might be casually asked to violate conscience just a little - a medical student, a nurse, someone else low on the totem pole? Such people, no matter where they work, need to know they have the protection of law, and it should be written into the health reform bill.

Resistance to writing in such language makes one pause. Do government leaders fear we’ll be overrun by citizens with consciences?

The battle over conscience rights extends into other areas. Should a doctor be forced to prescribe drugs he objects to, such as those that disrupt a healthy reproductive system? Should pharmacists be forced to fill a prescription for what they know may work by causing an abortion? We’re talking about professionals, here, not vending machines. Forcing someone to violate his or her conscience is an act of violence no civilized society should tolerate.

The poet John Donne said that “no man is an island,” that “any man’s death diminishes me.” Conversely, one might say that “everyone’s living by conscience enhances me,” for we are not isolated individuals but live together in society. Defense of the right to live by one’s conscience, be it an individual’s or an institution’s, helps guarantee access to quality health care reform for all. The defense of conscience rights needs to be written into the health care reform bill.
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