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Deadline nears for comments on health conscience rules

WASHINGTON (BP)–A pro-life U.S. senator’s effort to safeguard the conscience rights of patients and health-care workers went down to a resounding defeat as the Obama administration moved closer to apparent repeal of a regulation providing such protections.

The Senate defeated Sen. Tom Coburn’s amendment to the $3.5 trillion budget bill in a 56-41 vote. The roll call came a week before a 30-day public comment period closes April 9 on a proposal to rescind a rule by the Bush administration to protect medical professionals from coercion and discrimination. The Department of Health and Human Services (HHS) announced March 10 it planned to cancel the regulation, which was issued in December.

Health-care providers and patients may comment on the proposed repeal of the rule by e-mail. They may do so by e-mailing [email protected] and referring to “Rescission Proposal.” Or they may express their opinion to HHS through www.freedom2care.org, the website of a coalition established by the Christian Medical Association (CMA).

The final resolution of the rule regarding conscience rights could affect not only doctors but nurses, pharmacists, medical students, hospitals and insurance companies regarding such practices as abortion and assisted suicide and such products as the Plan B “morning-after” pill and contraceptives with abortifacient qualities.

Coburn, a Republican who continues to practice medicine in Oklahoma, designed the April 2 amendment to protect the conscience rights of health-care workers and the freedom of patients from being required to see a certain doctor or enroll in a specific health-care plan. The measure would have barred money in the proposed budget’s $634 billion health-care reserve fund from being used for such purposes.

“Like many pro-life doctors, I would go to jail before being forced to perform procedures, such as abortion, that violate my deepest held convictions,” Coburn said in a written statement after the vote. He has delivered more than 4,000 babies in his practice. “Medical ethics is based on the principle of ‘First, do no harm.’ I will fight to protect this Constitutional right as a physician and as a senator. Discriminating against health care providers by requiring them to disregard their deeply held beliefs is [an] assault on liberty.”

On April 8, CMA reported that 87 percent of adult Americans agreed in a recent survey it is important to make certain U.S. health-care workers “are not forced to participate in procedures and practices to which they have moral objections.”

The poll, conducted on the phone by The Polling Co., also found 62 percent oppose the Obama administration’s plan to rescind the Bush regulation. The polling firm also found in an online survey that 95 percent of faith-based doctors “would rather stop practicing medicine altogether than be forced to violate my conscience.”

A Southern Baptist biomedical ethicist said the Obama administration’s proposal could do great harm to health care in the country.

“Liberty of conscience is a freedom written into the very fabric of the American experience, not to mention into the virtues of a physician,” said C. Ben Mitchell, a consultant for the Ethics & Religious Liberty Commission. “To coerce a physician by law to take another human life by abortion, euthanasia or at any time in between is a violation of everything sacred in medicine.

“Medicine is not a consumer good, and physicians are not body plumbers,” Mitchell told Baptist Press. “They are professionals whose consciences have been unfettered since the Hippocratic Oath of more than 2,000 years ago. If the Obama administration thinks they can strip physicians of their consciences without destroying the profession, they are grievously mistaken.”

Mitchell, associate professor of bioethics and contemporary culture at Trinity Evangelical Divinity School in suburban Chicago, will begin teaching this fall at Union University in Jackson, Tenn.

Only three Democrats — Sens. Robert Casey of Pennsylvania, Ben Nelson of Nebraska and Mark Pryor of Arkansas — voted for Coburn’s amendment to the budget bill. Casey and Nelson had sent a letter to Obama March 20 calling on him to maintain the Bush rule.

“Discriminating against health care providers because of their consciences or forcing coercion into their practices would be a substantial deviation from our shared goal of reducing abortions in America,” Casey and Nelson said in the letter. “Therefore, we strongly urge you to preserve the conscience protection rule.”

The Senate approved the overall budget bill later April 2 in a 55-43 roll call.

A HHS official told The Washington Post the Bush rule was too broad and the new White House wanted to narrow the conscience clause.

The regulation issued by the Bush administration was intended to clarify that federal law protects the rights of institutions and individuals not to participate in abortion and other medical procedures to which they object on moral or religious grounds. The proposal placed into federal regulations congressional measures enacted in the 1970s through 2005 that “prohibit discrimination on the basis of one’s objection to, participation in, or refusal to participate in, specific medical procedures, including abortion or sterilization,” according to the HHS under Bush.

Noncompliance with the rule could have resulted in the withholding of federal funds to more than 580,000 hospitals, nursing homes, medical schools, doctors’ offices and other recipients.

The rule developed during the Bush administration after then-HHS Secretary Michael Leavitt became concerned about the willingness of the American Board of Obstetrics and Gynecology (ABOG) to protect the freedom of conscience of pro-life physicians. ABOG provides certification and recertification for obstetricians and gynecologists in the United States.

Leavitt wrote ABOG in March 2008 to seek clarification it would not support controversial recommendations from a committee of the American College of Obstetricians and Gynecologists. That committee said physicians “with moral or religious objections” should refer women seeking abortions to doctors who will perform them. The committee even said pro-life doctors should locate their practices near physicians who will do abortions.

ABOG’s response to his request “was dodgy and unsatisfying,” Leavitt said.

CMA has reported a survey of its members found 41 percent said they had been discriminated against or pressured because they adhere to pro-life standards.
Tom Strode is Baptist Press Washington bureau chief. With reporting by Michael Foust, an assistant editor of Baptist Press.