Lack of a conscience clause affects us all.

Found at www.usatoday.com vis Lucianne.com ;

WASHINGTON — Faced with a request to give an unmarried female patient a prescription for birth control pills, Dr. Michele Phillips looked to her conscience for the answer.

"I'm not going to give any kind of medication I see as harmful," said Phillips of San Antonio. The drugs would not protect her patient from "emotional trauma from multiple partners," Phillips reasoned, or sexually transmitted diseases. "I could not ethically give that type of medication to a single woman." (Note this medication is for possible consequences of a personal choice, not a drug to treat an existing condition. Unless promiscuity can be classified as a medical condition.)

After the evangelical Christian refused to write the prescription, she resigned her position. She now does contract work at a faith-based practice that permits her to "prescribe according to my ethical values."

Medical technology has surged forward in recent years, leading to many life-saving and life-giving procedures. At the same time, legal and ethical remedies haven't kept pace, and officials at the state and federal level are still working out how to address the sometimes competing needs and values of doctors and patients. (Note the implication that "legal and ethical remedies" are stuck in the past, therefore outdated.)

For example, the Obama administration announced last February that it plans to rescind regulations enacted at the end of President Bush's term that permit health care workers to abstain from performing procedures they oppose for moral or religious reasons. Eight months later, the administration has still not announced new rules. (Why should they? It works against their own interests.)

FAITH & REASON: Do you want the last word on medical care in your last days?
Often, experts say, the debate boils down to a question of convenience versus conscience, of personal choices affected by medical personnel.

" Do we really want co-workers deciding if our religious motivations and reasons are correct?" asked Joan Henriksen Hellyer, a postdoctoral research fellow at the Mayo Clinic in Rochester, Minn. (I'd guess a response might be, "Should medical workers park their personal beliefs at the door, regardless of the consequences those beliefs cite?")

For example, at the annual meeting of the American Society for Bioethics and Humanities here this month, a panel including Hellyer discussed the disparate dilemmas facing health care workers today, such as:

• A housekeeper who refuses to clean an embryonic stem cell lab. (At one time I considered that same scenario as applied to myself, building engineers/maintenance techs/handymen are needed everywhere. That includes abortion clinics. My decision was that if faced with performing work there or living under a bridge I knew several overpasses that were fairly nice.)

• An ultrasound technologist who doesn't want to work on Saturday.

• A respiratory tech who refuses to turn off a ventilator. (This seems to be a red herring. What could be involved with shutting off power and removing tubes that an LVN or nursing tech couldn't do?)

Bioethicist Holly Fernandez Lynch said consistency is crucial to prevent patients from facing discrimination based on race, religion or sexual orientation. (Bullcrap.)

"A consistent objection to a service, I think, is totally appropriate as long as there is someone available to provide that service at a reasonable distance," said Lynch, author of Conflicts of Conscience in Health Care: An Institutional Compromise. (And if there isn't? Are we back to medical professionals parking their beliefs at the door?)

But, she acknowledged, "the phrase 'reasonable distance' is really a difficult one to figure out."

While larger communities and hospitals have the luxury of a range of practitioners, conscience quandaries are trickier in smaller communities, said Leslie LeBlanc, managing editor of The Journal of Clinical Ethics.

"It's a very difficult question because you can't compel someone to do something they think is morally wrong and, by the same token, clinicians make a promise to help people in need," said LeBlanc, who attended the bioethicists' meeting. (Wait a second. What "need" are we talking about here? Abortion, euthanasia, birth control are all ELECTIVE in nature. Even euthanasia requires a judgement call, not like chemo for cancer. So where is the "need" she speaks of?)

State legislatures have passed a plethora of legislation on the issue, with most permitting health care providers to shun abortion services, the Washington-based Guttmacher Institute reports. Some states, including Louisiana, have passed broader laws that protect health care workers who object to procedures such as cloning, stem cell research, euthanasia and physician-assisted suicide. (All elective, nothing like the treatment of a disease/medical condition in anything listed.)

Rob Vischer, associate professor of law at the University of St. Thomas School of Law, argues for letting the free market determine access to all health care services.

"I think people want to have a space to live what they believe," said Vischer, author of the forthcoming Conscience and the Common Good: Reclaiming the Space Between Person and State. "I think that's more consistent with the common good than everybody grabbing for the reins of state power." (No kidding.)

Luke Vander Bleek, a Morrison, Ill., pharmacist is fighting in court against an Illinois regulation that requires him to dispense Plan B and other emergency contraception.

"I wanted to be able to practice pharmacy in this small town that I live in where I raised my family and I wanted to be able to do it with a good, clear conscience and sleep well at night," said Vander Bleek, a Roman Catholic.

He said other pharmacies within 12 miles could provide those services instead.

Elizabeth Nash, a public policy associate at the Guttmacher Institute, counters that patients should be able to access drugs if they are legal.

"Putting barriers in their way to access those medications only hurts public health," she said. (How does this "...hurt public health"? Aren't Plan B and other methods of contraception only "needed" when someone engages in sexual activity? Please don't cite rape to me, THAT isn't addressed at a local pharmacy such as this guy operates. Even rape shouldn't entail the use of contraceptives, but that can be addressed in another post. This article is talking about Joe Schmuckatelli, the local pill pusher, denying contraceptives to some broad that chooses to sleep around. )

As the arguments continue, Dr. David Stevens, CEO of the Christian Medical Association, said physicians like Phillips are "a growing reality" and he worries that other physicians might quit permanently. (Better to be working the fryolator at McDonalds than the forges of Hell.) In an April poll, his organization found that an overwhelming percentage of faith-based physicians preferred ending their medical practice to violating their conscience.

"This is the most urgent issue for our membership," he said. "Because they realize that if they lose this battle, they will no longer be practicing medicine." (And the public health will suffer then because these professionals, whose practice would entail MUCH more than anything their conscience prohibits, would NOT be addressing those other issues. The same pharmacist that leaves his job rather than dispense Plan B is the same guy that dispenses insulin to the diabetics in his area.)