Wednesday, March 26, 2008

On Ethics and the Workplace

Late last year, the ethics committee of the American College of Obstetricians and Gynecologists issued an opinion paper titled "The Limits of Conscientious Refusal in Reproductive Medicine". This is well worth the read- it addresses some of the core issues of the "conscientious refusal" movement that is so popular with wingnuts who happen to have a "Dr." in front of their names these days. Most pointedly, it asks the question- is it right for a doctor to impose their personal beliefs on a patient who may not share those beliefs?

Of course, the Bush administration couldn't resist being all buttinsky about the suggestion that doctors might have a greater moral obligation to put the well being of their patients before their supposed personal beliefs. HHS secretary Michael Levitt shot off a letter to the director of ACOG, stating in part:
I am concerned that the actions taken by ACOG and ABOG could result in the denial or revocation of Board certification of a physician who -- but for his or her refusal, for example, to refer a patient for an abortion -- would be certified.
In other words, the Secretary is concerned that a doctor who fails his or her duty to present all available options to their patient, and in the end do what is best for the PATIENT, might lose their license. These doctors, the Secretary is arguing, should be able to pick and choose what parts of their job they really want to do, and the big mean bossman shouldn't force them to do the other parts.

Let's step into the real world for a minute. Let's say my company entered into a contract to buy a chain of steakhouses. Naturally, as a vegan and generally ethical person, I have a strong moral objection to this, so I mention my objections to my supervisor, and ask that I be allowed to not participate in this transaction. He'll sit there patiently, hear me out, thank me for my input, and then wish me luck in finding a new job. Michael Levitt would not write him a letter begging him to reconsider, I'd bet.

The bottom line is, doctors (especially obstetricians and gynecologists) and pharmacists and their ilk shouldn't get a pass here. Their job is to operate in the public interest and in the interest of their patient, however personally distasteful they might find the patient's choice or the most logical treatment. If they don't find that the job suits their "conscience", they need to find another line of work.

And yet, Congress continues to prop up this notion that health care workers are somehow different from the rest of us when it comes down to doing our jobs. The Hyde-Weldon Amendment, inserted annually into a budget appropriations bill near you (gee, how'd that get in there?) codifies the following statement:

no federal, state, or local government agency or program that receives federal health and human services funds may discriminate against a health care provider because the provider refuses to provide, pay for, provide coverage of, or refer for abortion.
Oh, Henry Hyde. How we miss you- always hiding your anti-woman agenda in giant bills completely unrelated to the subject at hand. It's like a little easter egg hunt!

Anyways, to wrap this lengthy rant up, the government should not be in the business of telling organizations what their ethics should be, and health care professionals should decide what's best for their patients based on communication and medical knowledge, not their fear of where they might end up in some mystical afterlife. It's that simple really. And if you agree, I encourage you to let your health care providers and government officials know how you feel at every given opportunity. You are paying for their Mercedes and third vacation homes, after all. :)

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