When Conscience and Duty Conflict: A Health Care Provider’s Moral Dilemma

Verdict

David S. Kemp

Most of the time, physicians and other health care providers have coincident legal and ethical duties to perform their professional job functions. An emergency room physician’s obligation to treat patients admitted to the ER derives both from law and from ethics. A nurse’s duty to prepare a patient for surgery likewise comes from both sources. In some instances, however, a provider’s own personal beliefs may mandate one behavior while law and duty require another.

The most salient and most commonly discussed example in this context is that of abortion, and with regard to that procedure, the law is relatively clear: Providers who are morally opposed to abortions or sterilization may legally refuse to participate in those procedures. Similarly, in states that allow physician-assisted suicide, physicians who have moral objections to the practice are not legally obligated to engage in it simply because a patient requests it. In these cases, the law protects the provider’s right of conscience. . . Read More . . .

 

Quebec Doctors Forced Into Homicide?

 Human Exceptionalism

Wesley J. Smith

No one should be forced to kill or participate in killing. But if a recommendation of a Quebec euthanasia commission to legalize doctor-administered death are followed (discussed in more detail here) every Quebec physician will be conscripted to participate in homicide as a condition of practicing medicine.  Read more . . .

 

Proposed Amendment to HHS Regulation

Coverage of Certain Preventive Services Under the Affordable Care Act

Introduction:

The Obama administration has decided that, as a matter of public policy, individual women should not have to pay for “FDA approved contraceptive services,” which include surgical sterilization, contraceptives, and embryocides.  The reasons offered for this policy are mainly economic and socio-political.

A regulation was written by the U.S. Department of Health and Human Services for this purpose. The regulation requires all group health care plans (the kind of plan usually offered by businesses or oganizations) to offer coverage and fully pay for “preventive services” identified in Section 147.130 (reproduced below, in part).  Businesses with 50 or more employees must offer such coverage by 2014, or face penalties. Health insurance issuers (like insurance companies) must also make available group and individual plans that fully pay for “preventive services.”

The regulation sparked widespread protests and opposition from religious groups and, as of February, 2013, had generated 47 lawsuits launched by over 130 plaintiffs.  11 of 14 federal courts hearing the suits issued temporary injunctions to protect plaintiffs against the regulation.

In response, the Obama administration has issued proposed amendments to the regulation.

Update on American HHS birth control mandate controversy: January, 2013

The American Center for Law and Justice (ACLJ) has filed a lawsuit against the regulation on behalf of two Ohio companies [Lifenews]. A U.S. District Judge has dismissed suits  filed by the Archdiocese of Washington and four other Catholic nonprofit groups on the grounds that the suits are premature [Bloomberg] Lawsuits filed by Colorado Christian University and Notre Dame University in Indiana have also been dismissed [The Coloradoan; First Things].  The Catholic diocese of Nashville, Tennessee and seven other groups in the state are appealing a lower court ruling against them[The Tennessean].  In Illinois, a temporary injunction has been granted against state legislation that is similar to the HHS regulation because the state’s Religious Freedom Restoration Act and Health Care Right of Conscience Act [Georgia Bulletin].  However, the U.S. federal government is appealing a decision to grant a temporary injunction against the HHS regulation to Tyndale House Publishers Inc. of Illinois [Bloomberg].A temporary injunction against the HHS regulation has been granted to a Missouri company, Sharpe Holdings Inc., the third such injunction granted in the state [St. Louis Beacon].    Virginia Attorney General Ken Cuccinelli attracted criticism because of his remarks to the effect that the nature of the HHS regulation will only become apparent if people go to jail for refusing to obey it [Reason.com]

For a map and up-to-date overview of lawsuits filed against the U.S. Department of Health and Human Services, see the Becket Fund’s HHS Information Central.

Confronting Conscientious Objection

Engaging Bioethics
The Hoya, 31 January, 2013
Reproduced with permission

Maggie Little*

Conscientious objection. . . is not something lightly invoked. Its legitimate exercise brings with it strong obligations. Objecting providers must disclose their limitations early and often to minimize patient burdens. And they must convey those restrictions with compassion and respect. . . . The very premise of protecting conscientious refusal, after all, is that deeply good and reasonable people disagree on the issue. . .  Full Text