On its way out the door, the Bush administration has issued a new government regulation that will make it easier for health care workers to opt out of providing medical services on religious or ethical grounds.
A variety of groups, including Planned Parenthood and the American Medical Association, are warning that the so-called "conscience rule" will place new obstacles in the path of women and girls seeking reproductive health care.
The rule was issued Dec. 18 and will take effect the day before President-elect Barack Obama is inaugurated. It ensures that health care workers can refuse to participate in abortions, sterilizations or any federally funded health service or research activity on religious or ethical grounds.
Any employer who fails to accommodate such a worker will be subject to a cutoff of federal funds.
The rule is being hailed by conservative groups as a victory for freedom of religion and assailed by abortion rights advocates and other critics, who say it will restrict access not only to abortion but also to contraception, infertility treatment, assisted suicide and stem-cell research.
The regulation applies not only to doctors but to any worker involved in a procedure to which he or she objects, such as drug-store cashiers and hospital janitors who clean medical instruments.
The rule will affect nearly 600,000 hospitals, nursing homes, doctors' offices, pharmacies, laboratories, home health care services, medical schools and other entities at an estimated annual cost of $43.6 million.
"We're really concerned that this rule is going to have disastrous effects for women and their access to health care," said Courtney Jones, a grass-roots organizer at the Virginia League for Planned Parenthood.
For example, Jones said, a health care worker who opposes birth control could refuse to provide counseling for family planning. Or an emergency-room worker could deny a sexual assault victim information about emergency contraception that would help prevent an unwanted pregnancy.
But Jeff Caruso, director of the Virginia Catholic Conference, the public policy arm of Virginia's two Catholic dioceses, called the new rule "long overdue." Catholic hospitals refuse to perform abortions or sterilizations or provide emergency contraception.
"I think what's most paramount here is that individuals and institutions that are committed to healing should not be required to end the lives that they are dedicated to protecting, and they shouldn't be required to violate their own consciences or their religious beliefs," Caruso said. "I think this is really about nothing less than religious freedom."
Amy Vest, a pharmacist who works for a national retailer in Virginia Beach, also welcomed the regulation.
"It would allow me to go to work and perform my duties and not have in the back of my mind whether this would be the day that I would have to choose my beliefs over my job," she said.
Vest said she has a moral objection to dispensing the emergency oral contraceptive, which she considers equivalent to abortion. The so-called "morning-after pill," marketed under the trade name Plan B, has been available without a prescription since 2006.
Her employer already allows employees to opt out of ringing up the sale, Vest said, but that is inadequate protection for her as a pharmacist.
"It requires a licensed pharmacist to be on duty for the sale to occur," she said. "So I still felt party to the sale."
Obama criticized the rule when it was first proposed over the summer. The new administration could seek to reverse it, but that is a lengthy process. Sens. Patty Murray, D-Wash., and Hillary Rodham Clinton, D-N.Y., have introduced a bill to repeal it legislatively.
Bill Sizemore, (757) 446-2276, bill.sizemore@pilotonline.com






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Sorry, Fletcher! but . . .
Here's the confluence of free enterprise and the law of the land.
My religious beliefs lead me to find abortion reprehensible. Fine, I won't in any way work to facilitate one. Problem is there are lots of folks who believe like me who went into medicine (I did not) to heal, not to kill. They need a conscience clause or at least for us to segregate our facilities between secular and Catholic (I am using Catholic as a "catch all" because they are the most uncompromising pro-lifers I know--I am proud of them for that).
Then the ones who insist that every woman has a right to a quick, convenient abortion can just gather up the wagons and open facilities everywhere they think they are needed. Do that and stay off the backs of the people of deep belief who don't care to be involved in anything that makes money by killing babies.
I call nonsense
This is nonsense. Especially the et cetera:
"You really haven't been listening to the whole argument young ladies make about abortions needing to be available where they can get them without missing work, etc. "
There is a big difference between reasonable access to health care unfettered by irrational, personal beliefs about the spirit world (the requirement) and installing drive through abortion centers in every starbucks (your strawman). I'm confident you know the difference and dissapointed that you feign ignorance of it. The real horror is that your tactics here are typical of the anti women's healthcare rights crowd. These tactics seemed aimed at making no reasonable discussion possible.
Hey, Fletcher
You must be a guy. You really haven't been listening to the whole argument young ladies make about abortions needing to be available where they can get them without missing work, etc. Free enterprise could work that one, too, but a clinic on every other block downtown would still be too spread out for some young ladies used to getting things conveniently. And they loudly call out that people are denying them their rights if they have to drive five miles out of their way . . .
Yes, I do like the idea of different faith groups starting their own pharmacy chains. I give many $$$, almost daily, to the Walgreens across the street. Let them require their pharmacists to dispense abortion pills (or assisted suicide pills when it comes to that in Virginia). I will just give my dollars to places that are pro-life.
Extreme or ridiculous?
requiring medical professionals to act in the rational best interest of the patient does not equate demands for roving abortion clinics. I'm a bit taken aback at the suggestion. Minus two points for hysteria. You can get one point back if you try to make amends rank tactics. That said, I'm all for Wiccan faith (or other faith of your choice) medical facilities as long as declare their irrational beliefs up front and they don't siphon off resources from more useful and inclusive facilities. Let free enterprise reign. I'm not OK with the feds protecting the irrational actor(or person of faith) at my local pharmacy or walk in clinic who wakes up one day and decides that sweet baby Jesus, the two headed elephant god or the resonances from an ancient alien race don't want them to proscribe or dispense a drug or procedure and are thereby sheilded from real world consequences for their spirit based failings. There is likely a middle ground but lack of space and, in some part, temprament prevent me from describing it.
not a bad solution
Mary, I was thinking about that myself, although not necessarily a Catholic solution. I was thinking a about pharmacy owned / operated by whoever has an aversion to particular medications. My personal concern was not so much the morning after pill; for me the more 'radical' stance was the people who won't dispense birth control. As to your point about pharmacists doing more than dispensing pills... Nowadays, pharmacists do not prepare medications like they once did (It's a Wonderful Life springs to mind). The majority of the time they do, in fact, just dispense pills. Even their role ensuring there are no contraindications when several meds are prescribed has largely been taken over by computers. I am not trying to denigrate pharmacists at all, just stating the facts. I suspect that pharmacists are handsomely compensated because 1) tradition, 2) they require an advanced degree and 3) the consequences of making a mistake are so severe. In a 'public use' kind of pharmacy, I just don't think they should be able to decide which meds they'll dispense. The point about psych drugs was valid.
Two thoughts . . .
There will always be those who demand that other people serve as the means to their abortions, willingly or not. Take it to the extreme--what about a young inner city girl with no transportation whatsoever? For her convenience, should we put an abortion clinic on every city block? Or how about this--those of you who want to make it easy on her and others like her, develop a mobile abortion unit and go door to door. How much easier could it be?
On the other hand, there is a lot to be said for having Catholic/pro-life pharmacies, just like the Catholic hospitals that won't do abortions. Tell you what, if someone starts a Catholic pharmacy chain, I will use it. I wouldn't miss Walgreens and Rite Aid at all.
pick your argument
Either pharmicists are just pill counters or they are medical professionals, Mary. They aren't both. Pharmicists do, in fact, regularly dispense advice pertaining to medication along with the medication iteslf. They are supposed to do that. Now that they are empowered to practice their faith first and their craft second scenarios like the one I named might be defined as an act of conscience. (As a word wasting aside, I can't believe the woman who roughly equates gay marriage to marrying farm animals is being so fasiditous on this point). But let's look at similar scenarios for other medical professionals. A nurse or doctor who fails to provide information about contraception and abortion when counciling sexually active young women, for instance. A Christian scientist doctor who recommends prayer in lieu of a medical procedure. What happens if there aren't other doctors available? What if timing is critical? What about a doctor who sacrifices the life of a mother to avoid terminating a fetus during a difficult pregancy based on her belief that God will take care of it. What about a doomsday cultist?
CS and Fletcher . . .
First of all, most pharmacists would not agree with "just dispense the pills and get over it" as though they are not trained for anything more than counting pills (believe me, if that were the only job requirement, Walgreens and Rite Aid would be dispensing pills through a minimum wage person and not paying over $100,000 annually for a pharmacist).
Secondly, though the pharmacists have great expertise, they do *not* counsel patients. So the opposite extreme, of them trying to convert patients to Scientologists or Baptists, does not apply either. Chances are that we would not even know when one pharmacist refused to fill our order so another one had to be called in to do it. Few people wait right there for prescriptions anymore.
People are diverse and they have consciences. Do we not want them to honor their consciences? Doesn't that tend to dull them, so that suffering, loss of life, etc. soon don't bother them anymore? I choose to honor everyone's consciences, even when I disagree with their views.
Conscience
I do not like it when others inflict their religious beliefs on me. They have every right to adhere to their religious tenet of not taking contraceptives, opting for sterilization but if they are interfering with my rights to do the same that's where they might use their "conscience" and seek employment elsewhere. I would love "freedom FROM religion" imagine how it would be in a country that the Taliban had control using thier religious beliefs--some of the female practitioners wouldn't even be allowed to practice nor to gain an education to do so. Religious ideology has long enslaved groups of people and justified it under the tenets of the particular sect. Kinda like "my God says to do it this way not your way" That's fine you live your life your way and I will live my life my way but do not even try to restrict me from receiving good and treatment that are legal because of your conscience. Especially being in the same room while someone else actually rings up the sale. I would not even uses a pharmacy were such an incompetent works.
so what?
Conditions change in all sorts of professions and people may choose to continue to practice or not. It's irrelevant to me that the morning after pill is relatively new. The principle is the same - that a pharmacist shouldn't be able to pick and choose which legal prescriptions he chooses to fill. If the morning after pill is so abhorrent to a pharmacist that he doesn't feel he can dispense it, I respect his opinion. But he needs to hit the bricks and find a less morally objectionable (to him) profession. Incidentally, I was talking about birth control, which some pharmacists find objectionable, and this is not a new medicine. As I said before, plenty of people leave a profession because conditions change. Quite a few service members who really enjoyed serving in the military left because they didn't agree with the war in Iraq. Being true to one's conscience isn't always cost-free.
"Freedom", justanotheruser?
Freedom for whom? The only thing this insane rule accomplishes is to give preferential treatment to a small but loud group of Christian fundamentalists while placing an increased burden on women. That's not freedom. And you "recommend a phone call vs. running all over town", do you? Well, that's just great - except the pharmacy that's willing to help you may be 50 miles away and you have no transportation to get there. (Did you miss that part?) Look, it's very simple - if your job conflicts with your beliefs, then you need to either change jobs or adapt your beliefs. But your religious hang-ups should NEVER decide what kind of health care everyone else can access.
And does anyone else see the blatant discrimination in this idiotic rule? No other job, no other group is allowed to refuse to do their jobs based on a nebulous moral squeamishness, only health-care workers, and only Christians seem to need this bit of stupidity. That's illegal. If I refused to sell cigarettes to someone because I know they cause cancer and can kill people, or refused to sell a book that I found offensive, do you think I'd still have a job? Of course not. So why should these people be granted special p
Who should be the decider?
So you have a pharmacist who is a devout Scientologist and they work at a local drug store. There beliefs compel them to refuse to dispense medicine for depression, anxiety and neurosis. Instead they advise any person presenting such a prescription that these drugs are worthless and dangerous and to go to a church of Scientology to have their engrams evaluated and adjusted. Someone who suffers from neurosis takes this advice, stops taking their medicine, and begins looking into Scientology to cure their neurosis, after all the pharmacist proscribed it. However, early in our neurotics path to enlightenment they falter and commit mass murder instead. Where does the pharmacist stand?
Let's start our story again except substitute "Christian" for "Scientologist", "morning after pill" for "pysch meds," "go to Baptist Church" for "go to church of scientology" and "dies during childbirth due to pre-existing conditions" for "commits mass murder." This problem of service providers dictating life changing decisions based solely on personal beliefs is untenable. Those conscientious objectors should just quit.
Separation of religion from medicine
If a person has religious convictions that prevent them from performing acceptable medical procedures or filling prescriptions, they should look to get into another profession. Just because they have such religious convictions, they shouldn't have the right to inflict them on others seeking care or medicines.
Not so fast, MaryM
As a "Planned Parenthood type," as you put it, I can tell you that neither PP, nor anyone affiliated with it, would ever do anything to discourage anyone who wants to have children from having as many as they like. (That they discourage life is a popular and inaccurate misrepresentation put forward by the anti-choice movement because it suits their purposes to misrepresent other points of view.) PP does not tell people what to do. PP is about factual information that represents all points of view, good health, responsible decision-making and a safe, clean environment.
C.S.
Not so fast, buddy. This can work both ways. For historical note, the morning after pill was not available from most pharmacies until just a couple of years ago. People went through pharmacy school never knowing they would have to choose to keep their job, or not, over this issue. Let's make the situation backwards. If you were a Planned Parenthood type and had a woman who already had 10 children come in for a fertility drug that might give her three or four babies (let's just say she and her doctor are both very, very pro big families), would you want to have to fill that? You don't stop having a conscience just because you go through pharmacy or medical school.
Right on, CS!
Couldn't agree with you more! This regulation would seem to leave the door open for nurses or doctors who don't agree with DPT shots, or cosmetic surgery, or the use of computers. Where does this silliness end?
If you've chosen to work as a health care professional and can't stomach the current standards for care, you should probably be looking for work in another category (or at the least look for work in a Catholic hospital where many of the reproduction-related procedures you disagree with aren't performed). To say that you didn't sign up for this is a specious argument. Just about every job of any kind has undergone substantial change in the last 25 years. Things that were important when you started out aren't any more, or are done differently. Rather than pick and choose what you're willing to do based on your superstitions, why not be thankful you have a job?
find another line of work
If you are a pharmacist and have a morel objection to dispensing certain medications, you really ought not to be a pharmacist. There have been several instances where pharmacists refused to fill prescriptions for birth control pills because they had a moral objection to birth control. If a woman and her physician decide that a certain medication is appropriate for her, who is some guy (or gal) in a lab coat at Walmart to decide otherwise? If you're a pharmacist, you job is to dispense medicine. That's the deal. If you have a problem with that, find something else to do.
freedom of choice
Guarantees freedom of health care workes while preserving freedom of patients. Win-win.
Shanihah - I'd recommend a phone call vs running all over town.
Ellips - Nice try.
Aaaand once again...
...Marym63204 just Does. Not. Get. It. This rule doesn't just affect a woman's ability to terminate a pregnancy that she doesn't want. It affects her ability to terminate a pregnancy that might kill or disable her. It affects a rape victim's ability to protect herself from any further violation. It affects the health care of the thousands of women who take birth control pills for reasons completely unrelated to pregnancy - i.e., PCOS. It allows a complete stranger who does not know a single bloody thing about a woman to decide what health care that woman can and cannot have based on that person's own personal hang-ups. Marym, your "pharmacist woman" analogy only works if that pharmacist is choosing not to dispense Plan B to HERSELF, not when she makes the choice for another woman - in other words, you have the freedom to choose for yourself, but you don't have the freedom to choose for me.
Oh, and 1973 was 35 years ago. Are you trying to tell me that there have been no changes in medical guidelines, no new doctors or pharmacists? Please. Back in 1973 we didn't have MRIs either, and yet even older doctors know about and can order them now. Try again.
1973
Let me remind us that abortion on demand did not exist till 1973. Those who say doctors and nurses should have known what they were getting into have not observed the history of this movement. I don't think abortions moved into hospitals until years after 1973. Initially, clinics took care of them. So, no, not all medical personnel faced this choice in medical school.