Physician Conscience Blog III
I have on two previous occasions written in my blog about the principle of health care provider conscience. Federal law is explicit and unwavering in protecting federally funded medical practitioners from being coerced into providing treatments they find morally objectionable. This became a topical matter when the American College of Obstetricians and Gynecologists (ACOG) issued guidelines that could shape board certification requirements and necessitate a doctor to perform abortions to be considered competent.
Physician certification is a powerful instrument. Without it, a doctor cannot practice the specialty. Putting doctors (or any one who assists them) in a position where they are forced to violate their consciences in order to meet a standard of competence violates more than federal law. It violates decency and the core value of personal liberty. Freedom of expression and action are unfit barter for admission to medical employment or training.
As Secretary of Health and Human Services, I called on the organization that oversees Ob-Gyn board certification to alter its guidelines to assert that refusal to violate conscience will not be used to block board certification. Their answer was dodgy and unsatisfying.
Today, HHS will file a rule in the Federal Register aimed at increasing compliance with existing federal laws protecting provider conscience. The proposed rule clarifies that non-discrimination rules apply to institutional health care providers as well as to individual employees working for recipients of certain funds from HHS. It requires recipients of certain HHS funds to certify their compliance with laws protecting provider conscience rights. The HHS Office for Civil Rights is designated as the entity to receive complaints of discrimination addressed by the statute or the proposed regulation.
The proposed rule also charges HHS officials to work with any state or local government or entity that may be violating the law or the proposed rule to encourage voluntary steps to remedy the problem. If they fail to fix the problem, it empowers HHS officials to consider a range of sanctions including termination of funding and the return of funds paid out while they were in violation. The proposed rule is open for comment in the Federal Register for 30 days.
Our nation was built on a foundation of free speech. The first principle of free speech is protected conscience. This proposed rule is a fundamental protection for medical providers to follow theirs.
Posted on August 21, 2008 in Physician Conscience
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Thank you Dr. Leavitt.
Our nation can be said to be based on "life, liberty and the pursuit of happiness"(among other ideals) and not freedom as is a common misconception. As such, any and all laws and other policies must adhere to these and other basic tenants that are found in our constitution. Utilizing one's conscience while making choices must also adhere to these tenants when it comes to one person relating to another in our society. This legal issue governs life in these united states. As such, the currently discussed ideal of protecting a life being placed over the ideal of individual choice to end one adheres most to the legal and spiritual tenants of our Declaration of Independance.
Posted by: John R. Gagne | December 22, 2008 at 02:23 PMDear Mr. Leavitt,
Thank you for forcing women to get back alley abortions and die from the infections. Thank you for incresing the number of unwanted pregnancies in the United States, which has the highest rate of STIs and unwanted pregnancies than any other Western country. Thank you for continuing the oppression of women, encouraging patriarchal values, and proving again how ignorant of science our nation is.
Posted by: Alyssa | December 03, 2008 at 05:37 PMWhy is the right of the doctor to have a "clear" conscience so important, but the right of a woman (or man)to obtain birth control is not? How can a doctor sleep at night if s/he has spent their day denying birth control access to people who may have no other way to get it? Would we rather that these people catch STDs (from lack of condoms) and have children that they are not prepared to care for? I thought that the Republican Party was for responsible parenting, but if you're just going to force women to have children that they cannot care for (and are trying to prevent), guess what that leads to? WELFARE!!! Le gasp!
Posted by: Jillian | December 02, 2008 at 04:24 AMI am so proud of this administration for standing firm on matters of concern for the American people, particularly the issue of protecting the conscience rights of the medical community. No one should be disallowed to follow their constitutional rights. Thank you!
Posted by: Pamela A. McDonough | November 30, 2008 at 07:54 PMThank you so much for your strong stand on principle when it comes to the moral and ethical consciences of doctors and practitioners.
We are sorry to see you going soon, but please continue to do all you can to solidify federal law in upholding the consciences of all medical personnel.
Sincerely hoping for a miracle on pro-life issues with the next administration.
Posted by: Sandy Sasso | November 29, 2008 at 08:42 PMThank you, for preventing physicians from providing women with basic health care. Thank you for allowing physicians to force their own beliefs on their patients, and from preventing women from getting quality care because their values differ from those of the physician's.
Posted by: Amanda Bealy | November 29, 2008 at 05:18 PMThank you, sir, for upholding the right of physicians to refuse to perform abortions. They have taken the oath to preserve life and that, only, should be their "choice" and right.
Posted by: Mary Dekkers | November 28, 2008 at 09:28 AMSecretary Leavitt, I just want to say thanks for upholding the right of medical personnel to refuse to perform acts that they believe to be morally wrong.
Posted by: Virginia | November 25, 2008 at 03:57 PMDear Secretary Leavitt,
Thank you for protecting people's consciences by being against the forcing of pharmacists to dispense abortifacient drugs and for being for medical providers to follow their own pro-life consciences and not be forced to perform abortions, etc.
Posted by: Anna O'Donnell | November 24, 2008 at 12:51 PMThank you, Sec. Leavitt, for your work on behalf of the conscience rights of medical professionals regarding abortion. I know that time is short, but I hope you can set something in place that will be difficult for the next administration to overturn.
My thanks also to President Bush who is supporting your efforts.
Posted by: Karen Burke | November 24, 2008 at 11:13 AMThank you, Mr. Leavitt, for your clear articulation of the true issues at hand and for you work to protect freedom of conscience. In a nation where it seems that all ideologies can now be tolerated and praised except for those based on Judeo-Christian beliefs, we deeply appreciate you fighting to protect our personal freedoms too. Thank you!!
Posted by: Tana Anderstrom | November 22, 2008 at 11:03 AMSec Leavitt,
Posted by: Col (Dr) Christopher J. Lisanti (ret) | November 21, 2008 at 09:04 PMThank you so much for your work regarding physician conscience. This is essential in our day and age when the public is increasingly looking at us less as a profession and more as a business. It is also essential as people look at their whims and desires for convenience as "rights" which trump over 2,000 years of medical ethics. Your stand for truth and what is right while protecting rights of conscience of physicians throughout this country will not be forgotten.
Thanks again for your service to our country.
Col (Dr) Christopher J. Lisanti (ret)
Thank you so much for standing up for the consciences of physicians, nurses and pharmacists. "Do no harm" is paramount to the medical professions and should be protected at all costs. I am thankful that my nurse sisters do not have to take part in an abortion or in physician assisted suicide, and that pharmacist friends do not have to fill prescriptions to end a pre-born life or end a life that is painful because of advanced disease. If doctors were forced to leave the profession because they were not allowed to live by their convictions, then where would we be? Unethical, immoral practices would abound. History has proven that in many instances. Just look at China today. With their policy of only one child per family, women who want to have a second child are hunted down like animals and forced to have abortions. Is that ethical? Is that protecting life? Is that "health" care? Is that where we are headed as well? I shudder at the thought! God bless you for standing up to the liberal anti-life factions out there. Stand strong.
Posted by: Jane Butledaob | November 21, 2008 at 08:24 PMGood for you, Secretary Leavitt. I only wish the rule could be made so ironclad it could not easily be undone. More dark and terrible days (for the life of innocents) lay ahead, but at least your efforts will help delay the increased slaughter of innocent life. Ironic isn't it, how the haters of life call the unrestricted destruction of life access to health care. Health care? They really believe the murder of innocents is health care do they? I know they know it isn't about health care at all. But then I also know this present battle against abortion is not a battle against flesh and blood either. The most effective weapon is not just prayer, but a spirit of self-sacrifice, such as fasting and saying no to oneself. Prayer, united to fasting, will do more to destroy the powers that propel abortion than any legal construct. Even so, thank you.
Posted by: John Hladky | November 21, 2008 at 06:30 PMI just want to thank you for supporting a rule that allows a hedge of protection around health care providers who object to abortion or other procedures on moral grounds and allows them to act according to their conscience.
Posted by: Kim Blair | November 21, 2008 at 02:52 PMI am in 100% agreement that noone including physicians or religious institutions should be forced to provide a service they believe is clearly immoral. Thank you for the rule that would create a hedge of protection around health care providers who object to abortion or other procedures on moral grounds. Nice work and very much appreciated, Secretary Mark Leavitt.
Posted by: D Johnson | November 21, 2008 at 01:14 PMDear Secretary Leavitt,
Thank you for creating the rule that will create a hedge of protection around health care providers who object to abortion or other procedures on moral grounds. These providers - pro-life doctors, nurses, or other medical workers, as well as pharmacists need this protection, and I affirm you in your work and decision. As I understand it, the rules will be a giant leap forward for the entire medical community--especially those who have been pressured to compromise their convictions on the job.
As you wrote earlier, "Our nation was built on a foundation of free speech. The first principle of free speech is protected conscience. This proposed rule is a fundamental protection for medical providers to follow theirs."
Thank you again for upholding the office you represent, and the moral obligations of the citizens of the country you serve.
Posted by: Dave | November 21, 2008 at 10:07 AMThanks so much for standing up for the conscience of medical professionals! For far too long, liberal elites and big business have forced pharmacists to violate their consciences by distributing morally objectionable drugs. Finally, our pharmacists can have their freedom of speech and religion restored.
Posted by: John | November 21, 2008 at 07:59 AMThank you for your perseverance on conscience protections. Abortion is clearly not a "health care" issue, and no physician or health care provider should be forced to participate in such procedures in violation of his or her conscience or faith. Please continue to work on these protections.
Posted by: Gabriela Probst | November 21, 2008 at 07:36 AMDear Secretary Leavitt, Thanks for fighting to protect and support health care professionals, their choices, and the right to not violate their conscience!
Posted by: Bjorn | November 21, 2008 at 01:27 AMThank you so much for your hard work in helping to protect the rights of health care providers. I am a pharmacist and I know firsthand what this protection means to me and my profession. Thanks again!
Posted by: Angela | November 21, 2008 at 12:41 AMThank you sir for your service to this country and current administration. I greatly appreciate your pro-life stance. Our first basic right is the right to life.
Posted by: Steve Cook | November 20, 2008 at 10:12 PMDear Secretary Leavitt,
Just writing to let you know I completely support your efforts to protect health care workers from being coerced into providing treatments they find morally objectionable.
Sincerely,
Heather Raleigh, NYC
Posted by: Heather Raleigh | November 20, 2008 at 10:08 PMDear Mr. Leavitt, I want to thank you for giving a true picture of courage in standing up for your beliefs and for the all the rest of us who also believe as you do. The killing of innocent children will always be wrong no matter how politically correct it becomes.
Posted by: Mkell Fuhrmann | November 20, 2008 at 10:01 PMThank you, Secretary Leavitt, for your leadership. You and President Bush have taken on a formidable task and I praise you both for your willingness to fight for the rights of all health care providers. Those rights extend to matters of conscience. If medical professionals are not permitted to consciously object to procedures, pills, etc. that terminate life, then they have no recourse except to quit or stand quietly by giving tacit approval to an action they abhor. Neither is tenable and action must be taken before January 20th to preserve their rights.
Martin Niemoeller once wrote:
First they came for the Communists but I was not a Communist so I did not speak out.
Then they came for the Socialists and the Trade Unionists but I was not one of them, so I did not speak out.
Then they came for the Jews but I was not Jewish so I did not speak out.
And when they came for me, there was no one left to speak out for me.
Now is the time to speak out! I'm using mine to speak for the unborn, pre-born and partially-born. Do you hear me now?
Posted by: Melissa Shoreham, VT | November 20, 2008 at 08:01 PMDear Secretary Leavitt,
As a daughter of an OBGYn who spent many hours working in my mother's office, I have recollections of when my mother would counsel women not to kill their unborn children. I am thankful for the freedom in this country for the exercise of conscience on moral matters. You see, we are from India where abortion is a common occurance--even for sex selection. God bless America and Americans who stand up for Life.
Posted by: Thelma | November 20, 2008 at 06:25 PMTHANK YOU, Secretary Leavitt, for your work to protect health care professionals' ability to ply their expertise in healing and helping humanity without being forced to violate their moral regard for the sanctity of human life. I know that you hear from very vocal objectors to your position, but want you to know that there are more people who appreciate your dilligence in this important work. In all human rights, the rights of an individual end as soon as they begin to infringe upon the rights of another. The rights of a woman do not supersede the rights of an unborn child or the rights of health care professionals to adhere to their own religious or moral principles. There are many other "choices" available to women all along the way.
Posted by: Kathy H | November 20, 2008 at 05:34 PMSecretary Leavitt -
I recently read that you would be do all you can to protect freedom of conscience for health care workers before you left office. I appreciate your efforts as I have been sorely concerned about the turn the HHS Department will take after the new administration is put in place in January. Thank you for your efforts on behalf of our nation and our freedom and our basic rights.
Posted by: Annie B | November 20, 2008 at 05:34 PMThank you Secretary Leavitt for courageously taking steps to preserve basic freedom which seems to be increasingly under attack.
Posted by: Grant Duffin | November 20, 2008 at 05:17 PMThank you so much for your efforts to protect the consciences of health care professionals regarding the practice of abortion. No one should ever be forced to participate in something which they regard as abhorrent and evil!
Posted by: Marilyn Joan Brauning | November 20, 2008 at 04:51 PMSecretary Leavitt, I want to thanks you for standing up for health care workers' rights!
Posted by: | November 20, 2008 at 04:51 PMDear Mr. Leavitt
Protecting our conscience is the only guarantee for democracy and freedom. It is not a religious privilege, it is a human rights imperative.
As a physician, I particularly thank you for your work to ensure that our conscience is not being trampled on. Although most people would only connect this issue with the right to refuse to perform an abortion, the question is deeper than that. If I cannot exercise the right to decide what is best for a patient, who takes responsibility for the outcome? Not me!
Protecting everybody's conscience will also protect the conscience of those who believe that performing abortions is their call to save humanity. So be it. But it will ensure that inalienable right to act following what one's conscience dictate.
Posted by: Sonsoles de Lacalle | November 20, 2008 at 04:37 PMI want to take a moment to express my gratitude to yourself and President Bush for working so diligently to protect the right of physicians to stand by their convictions by not participating in procedures which end the life of an unborn child without professional ramifications.
Thank you so much! It gives me hope for our nation. Your efforts do not go unnoticed.
Sincerely, a fellow citizen
Posted by: Dawn Justice | November 20, 2008 at 03:04 PMThank you for working to prevent the coersion of physicians and nurses to do harm to the unborn and those who will be euthanized. Such decisions are difficult enough without threats to their professional carreers. May God bless your work.
Posted by: Todd Cloninger | November 20, 2008 at 02:16 PMOur democratic system of government is designed to allow the voice of the people to shape our laws. So, in general we as a people decide, for each medical procedure, whether the conscience right of the doctor/nurse outweighs the access right of the patient, or vice versa. You cannot use one procedure, such as birth control, to argue a position for other procedures, such as abortion, because the level of violation of the doctor's conscience vs. the patient's access rights are different in every case. I think we should start by deciding what the law should be for ABORTION only as a first step. Abortion is killing a living human being. We're talking murder here of the most defenseless of all classes of human beings. I personally think that in this case, the law should lean towards the doctor's right to not commit murder, vs. the patient's right to have somewhat harder access to the procedure. The idea that I should be able to conceive a child for my own sexual pleasure and then take that life away at any moment I want for any reason, or end that child's life because the pregnancy is inconvenient to me, or demand that no difficulty whatever be placed between me and killing that baby, is simply selfish and hard-hearted. Thank you, Mr. Leavitt, for taking a stand on this issue.
Posted by: Matt Carmack | November 20, 2008 at 02:15 PMMany thanks to Secretary Leavitt for his efforts to insure that the provider conscience clause is made permanent in the HHS procedures and policies. As he says, our country is built on freedom of conscience, and those who object to medical procedures, such as abortion, should not be forced to do them, nor to participate in them. And further, physicians who so exercise this conscience clause should not be penalized in any way, either by the medical profession, nor by any committee of said profession. Rather these people are honoring the long-standing admonition of "DO NO HARM," the Hippocratic Oath that seems to have been jettisoned long ago in order to accommodate the radical and liberal mentality in medicine ushered in by the Supreme Court's rendering of its infamously wrong judgement in Roe vs. Wade in 1973. I hope that in in not too distant future this case is overturned and the rights of an unborn child in the womb are recognized in law.
Posted by: Geraldine Nordsieck | November 20, 2008 at 02:03 PMThank you Dr. for standing up for the rights of medical workers to not give treatment that violates their concience. If you were told to murder someone for them, you could refuse. Abortion is murder.
Posted by: Faith | November 20, 2008 at 01:56 PMI appreciate your moral courage in supporting the rights of those physicians who choose not to perform abortions. Your efforts are appreciated.
Posted by: D. Williams | November 20, 2008 at 01:42 PMAloha Secretary Leavitt
Thank you so very much for giving our health care professionals the choice to do what is right. You have given many the opportunity to act upon the very reason why so many get involved in the health care profession - to help others in need of care. Your actions will help to keep many in the field of health care as well as helping to save the lives of the most innocent.
Mahalo Nui Loa!
Posted by: Lee Richard | November 20, 2008 at 01:39 PMThank you, Mr. Leavitt, for supporting issues of being Pro-Life. It's amazing to note how many people don't stop to think that the only reason they are alive is because their Mom was Pro-Life. The only reason a person can be Pro-Abortion is because their Mom was Pro-Life. If the people that support abortion would have had a Mom that was Pro-abortion, they would not be here to be Pro-Abortion. Being Pro-Abortion is logically a dead-end street figuratively and literally.
Posted by: Byron | November 20, 2008 at 01:10 PMThank you for working on this - we support you 100%
Posted by: Heather from Alaska | November 20, 2008 at 12:53 PMDear Secretary Leavitt:
Posted by: Robert E. Williamson | November 20, 2008 at 12:53 PMMy sincere thanks for your efforts on behalf of conscience protections for medical practioners. You are genuinely appreciated.
Thank you Secretary Leavitt for introducing this rule which will protect those doctors and nurses who have solid moral convictions and who uphold life as sacret.
Posted by: Maria | November 20, 2008 at 11:43 AMI want to thank you so much for protecting our Christian Heritage, what our founder fathers faught for, our freedom to choose. These doctors, nurses, and pharmacists will greatly appreciate what you have done, as well as the rest of us with a Godly conscience. God is in control.
Posted by: Phoeby Gibbons | November 20, 2008 at 11:39 AMThank you again for your hard work and I pray this will take place before Bush leaves office.
Until the people so concerned with choice finally admit to themselves, based on scientific fact and not a matter of opinion, that life begins at conception, they will never admit that abortion is infanticide.
So how about all of the pro-choice people consider this: stop inflicting your beliefs on the rest of us who actually value both women and children.
Keep up the great work, Sec. Leavitt. And thank you for allowing some real choices to be made.
Posted by: Heather | November 20, 2008 at 11:36 AMDear Secretary Leavitt,
Thank you for your courage in defending the rights of medical practitioners who object to abortion on moral grounds!
Paul
Posted by: Paul Stackhouse | November 20, 2008 at 11:15 AMSecretary Leavitt,
Thank you for taking a stand for life and enabling doctors and pharmacists to do the same. As a pro-life woman, I want to know that my doctor is pro-life as well, so this is an important step for me. I had an experience with my former neurologist that made me see how important this really is for me personally. I had been going to this particular doctor for several years for migraine treatment. However, when I casually mentioned during a consultation that I was actively pro-life, she verbally attacked me in the exam room (nobody else was present), bringing up legislation such as the partial-birth abortion ban and a law we have been trying (unsuccessfully so far) to pass here in our state. She also attempted to argue rather harshly in favor of embryonic stem cell research, and even brought up a couple of other issues for good measure. Her "attack" went on for nearly 10 minutes, and when she finally realized she wasn't going to back me down or intimidate me into giving up—I've worked in various pro-life causes for nearly 20 years, and wasn't about to let her medical credentials cower me into submission!—she told me I would have to find myself another doctor, because she "didn't think she could treat me objectively, knowing what (my) views are on this issue." That, by the way, is a direct quote; I wrote up a complaint of the experience and sent it to our local medical ethics board, but of course nothing was done.
I did realize at that point, however, how important it is to have a doctor who shares my pro-life views; what if this doctor who obviously radically opposes pro-iife views were to do surgery on me and had to make a life or death decision concerning me while I'm unconscious on the operating table? I certainly don't want her to be the one to make such a decision! In the same way, if I were still of childbearing age, I absolutely would want my OB to be staunchly pro-life, as mine was! I want to KNOW that he/she would do everything in his/her power to bring my child into this world safe and healthy, no matter what. If someone else feels differently, that person is free to find a doctor with differing views; that is why it's a "physician conscience" law! But don't FORCE my doctor or my pharmacist into doing something he is bound by his honor, conscience, and his God not to do. That, in my way of thinking, is what makes him the best doctor FOR ME!
Again, thank you, Secretary Leavitt, for taking this stand for those of us who share this conviction and want doctors/pharmacists who feel similarly.
Posted by: Lee Bailey | November 20, 2008 at 11:12 AMThanks for your work on protecting the choice of individuals to provide (or not provide) services. I see this as a basic freedom that, when intruded upon, will drive good people out of certain industries.
Thank you,
Posted by: Morgan Seegmiller | November 20, 2008 at 11:07 AMThe Hippocratic Oath came about because Greek physicians dealt in both killing and curing. It got to the point where Greeks feared their physicians and Hippocrates knew that had to change. Thus the Hippocratic Oath begins with a promise to do no harm, and until the mid 1970's included a promise not to give a woman anything that would cause her to abort. German hospitals are packed because the Dutch have rejected Hippocrates' wisdom. Those who cure should have no part in killing. Thank you Sec. Leavitt for your courageous efforts to keep sanity and integrity in the healthcare profession!
Posted by: Mrs. Sharon Conklin | November 20, 2008 at 10:57 AMThank you for protecting the conscience rights of health care providers, and for taking a courageous stand against those in the abortion industry who would want to deny those rights.
Posted by: Pam | November 20, 2008 at 10:51 AM