Wednesday, August 30, 2006

I Solemnly Swear I Am Fed Up With Doctors' "Right to Refuse"

Recently, one of CNBC's Donny Deutsch's "Big Ideas" was to interview Darlene Bender, whose 20-year-old daughter was raped and later denied emergency contraception by her ER doctor at Good Samaritan Hospital in Lebanon, PA last month. Deutsch cannot believe that the doctor would put his personal beliefs before those of his patient-that he had the "audacity to take that decision [to provide emergency contraception] upon himself." You go, Donny.

Dr. Donna Harrison, from the American Association of Pro-Life Obstetricians and Gynecologists joined the dialogue and was introduced as someone "offensive" to Donny because she stands behind Dr. Gish's refusal to provide emergency contraception to the young woman. Dr. Harrison asserted that physicians have a right to refuse to prescribe medications and that requiring doctors to do so would be "against the Hippocratic oath." Her Hippocratic oath included a promise not to have sex with her patients, a promise not to give a drug which would kill someone, and a promise not to destroy human life before birth. Her oath did not seem to involve treating patients with whom she disagrees inhumanely.

For some reason, the last bit didn't sit well with me (I'm sure you can't imagine why). According to Wikipedia (the most succinct explanation of the Hippocratic Oath):

Several parts of the oath have been removed or re-shaped over the years. . . as the social, religious, and political importance of medicine has changed. Most schools administer some form of oath, but the great majority no longer use the ancient version, which praised non-Abrahamic deities, advocated teaching of men but not women, and forbade general practitioners from surgery, abortion, euthanasia, or abuse of the prescription pad.


The actual oath may not have even been written by Hippocrates; instead, it has been attributed to the Pythagoreans of fourth century BC.

It sounds to me like you can swear on whatever you want to swear on-the ancient Hippocratic Oath, the Declaration of Geneva, Dr. Harrison's anti-choice oath, or the Oath of Lasagna (and no, I'm not just trying to be funny with a reference to a favorite cartoon orange cat, this is a real oath!). Dr. Harrison has held true to the anti-choice part even though emergency contraception can't cause an abortion (surely because we're still living in conditions similar to ancient Greece, where it was dangerous to perform abortions or they, too, would've continued confusing how EC actually works) and obviously opted out of adhering to the "teaching of men but not women" and worshipping Apollo. Clearly, justifying the right to refuse medical treatment holds up when an ancient oath that really isn't used anymore or taken literally is your justification.

I guess another oath that should remain forever the same is a woman's vow to obey and serve her husband in marriage. Woulds't thou concur, Dr. Harrison? Sadly, the answer is probably yes.

Darlene Bender, who appeared on Donny's show, will be one of several speakers at a press conference for the Pennsylvania Compassionate Assistance for Rape Emergencies (CARE) Act on September 13.

Julie in Philly

11 Comments:

Anonymous Atheism Quotes said...

If there's one thing these people are good at, it's picking and choosing which close-minded, hurtful, hateful parts to use to do the most damage.

I personally think a patient in a situation where they don't have a choice of doctor should never have to be afraid that the doctor assigned to them won't administer the best and most appropriate care needed.

7:45 PM  
Blogger Sheikh Mahandi said...

Does the AMA take a similar stand to this "Dr", or are they more of the opinion that treatment should have no reliance on personal beliefs? If the latter, perhaps the original doctor should be investigated by the AMA and disciplined by them?

6:55 AM  
Blogger ACLU of Pennsylvania said...

I asked 2 doctors on our board, and neither of them knew. I did a quick search on the AMA's website, and it seemed like this is still a controversial issue w/in the organization. Here's one op-ed from their site that I thought was helpful (of course, maybe because it supports our side :) ).

The Growing Abuse of Conscientious Objection

http://www.ama-assn.org/ama/pub/category/16185.html

Sara in Philly

12:31 PM  
Anonymous Atheism Quotes said...

What a fascinating article! VERY clear and well written.

I guess the ultimate issue is whether the patient's right to live is outweighed by the doctor's right to discriminate against the patient based on their religion.

Sad that the religious discrimination seems to be winning in some places.

1:18 PM  
Anonymous Keanus said...

Conscientious objection entails a willingness to pay a penalty for following one's convictions. When a physician witholds services as a conscientious objector, such as advice or guidance on an abortion, he/she is compelling his/her patient to pay the penalty, not him/her. That's flatly wrong. The same argument applies to the pharmacist who refuses to fill a prescription for Plan B or contraceptives. The AMA essay, with respect to physicians, makes this abundantly clear.

10:13 PM  
Anonymous Anonymous said...

What about the Doctor's religious liberty rights? Surely, an organization that holds up the First Amendment as high as the ACLU would endorse the right of that doctor to practice and follow his religious beliefs.

Or does the ACLU now believe that one has a right to conscientious objection when drafted (as seen during the Vietnam war), but not a right to refuse to perscribe drugs according to one's religious beliefs.

This sounds like hypocrisy to me.

8:20 PM  
Anonymous Anonymous said...

A doctor certainly has the right to refuse to perform a service if it violates his convictions.

However, I believe if that doctor is an employee than his employer should have no obligation to refrain from disciplining him or retain him as an employee.

Religious freedom in the workplace does not mean you get to decline to fully participate in your employers mission yet still get to keep your job or receive full pay.

2:44 AM  
Anonymous Anonymous said...

So its OK for a doctor to have religious beliefs but he should be punished for practicing those beliefs?

Would you support feeding doctor's who practice their religion to the lions? Becuase, hey, its OK if they practice their religion, but the penalty for doing so is death.

Sounds like a flimsy defense of your argument.

11:16 AM  
Blogger ACLU of Pennsylvania said...

A doctor certainly has the right to refuse to perform a service if it violates HER or his convictions (I had to do that because it really bugs me when people speak about certain professions in only one gender). However, that doctor has an obligation to the patient to provide uninterrupted treatment which may require that doctor to find another doctor who is willing to perform a particular service. If s/he fails to do so, that doctor is forcing her/his religious beliefs on the patient and ultimately harming the patient by not meeting her/his healthcare needs.

Religious refusals are most contentious when they apply to reproductive health services. As a defender of the First Amendment, the ACLU supports anyone’s right to follow her or his own religious beliefs as long as they aren’t harming others. At the same time, the ACLU views reproductive freedom as a core civil liberty and a foundation to the right to privacy. Religious objections should not stand in the way of a woman receiving reproductive health services.

My personal opinion is that if an emergency room doctor or a pharmacist objects to providing certain services, like dispensing emergency contraception, that doctor or pharmacist should seek another profession or specialize in something like podiatry or dermatology. In that capacity, s/he would be free to hold their own religious beliefs and, (hopefully) their beliefs wouldn’t interfere with the treatment of my feet or my skin. I wouldn’t want to take a chance and go to an emergency room or a pharmacy for a time-sensitive medication and find out that my doctor or pharmacist refuses to help me.

Check out this document created by the national ACLU’s Reproductive Freedom Project entitled “Religious Refusals and Reproductive Rights” at http://www.aclu.org/FilesPDFs/ACF911.pdf

Julie in Philly

5:41 PM  
Anonymous Anonymous said...

I was one of the supporters of the ACLU back when donors were running from the organization when it became involved in defending the Neo-Nazi's right to march. But, I have stopped supporting the ACLU lately becuase of issues such as this.

Instead of fighting for our core liberties, which are enumerated in the Bill of Rights, the ACLU has invented liberties such as reproductive freedom.

Now the ACLU has decided reproductive freedom is on a higher pedestal then religious liberty. The only problem is that religious liberty is grounded in our Bill of Rights while reproductive freedom is, at best, a modern interpretation of the living constitution.

Practicing and following one's religion is NEVER forcing it upon another person. In a free society, people will inevitably have to deal with others that have differing beliefs. I use to manage a company and I had to allow my Muslim employees to pray during the day (even during meetings), I gave Jews off on the sabath, and would not schedule Christians for Sundays if requested. Even though I was inconvenience on occasion by these religious beliefs, this was in no way forcing their beliefs upon me.

Also, I take issue with the statement "the ACLU supports anyone’s right to follow her or his own religious beliefs as long as they aren’t harming others." Statements much like this one have been used in the past to justify the gradual erosion of our basic rights. In the late 80's it was used to justify speech codes. Proponents would say, "we believe in free speech and freedom of expression, until it infringes on the rights of others". Today, the Bush Administration and the extreme right wing use similar statements to justify the erosion of our 1st, 4th, 5th and 6th amendments. I am shocked that the ACLU would use such rhetoric.

Although accomodating work schedules does not equally compare to emergency contraceptives, there is almost never a reason to force someone to violate their personal and deeply held religious beliefs in the name of "reproductive freedom".

Would the ACLU force a devout Muslim to perform an emergency abortion, which would be considered abortion under Islamic doctrine, or face discplinary proceedings? I certainly hope the answer is NO.

10:53 AM  
Blogger ACLU of Pennsylvania said...

Is it really forcing a doctor to violate their religious beliefs to 1)acknowledge that their beliefs may impact the care of their patient and 2)identify another healthcare provider who would offer services that align with medical judgment AND the patients' beliefs? I think that's just expecting someone to act as a responsible professional.

I'm sorry that you feel reproductive freedom is not a core civil liberty similar to religious liberty. As a woman, I see my decision about if and when I will bear a child as a fundamental right. I don't think anyone at the ACLU would say that reproductive freedom is higher in a hierarchy of rights than religious liberty (or vice versa), though.

However, you are not alone in your struggle to understand why this is an ACLU issue. As a social worker who's education was not based in the Constitution and Bill of Rights, I do not feel I am the best resource to provide you with an adequate response. I will seek a clear answer from some lawyer folks and get back to you.

Julie in Philly

3:53 PM  

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