Signal Boost: “Conscientious Objectors” in Health Care

From “Why We Need to Ban ‘Conscientious Objection’ in Reproductive Health Care,” by Joyce Arthur, Abortion Rights Coalition of Canada, and Christian Fiala, Gynmed Clinic for Abortion and Family Planning. Published at RH Reality Check, May 14, 2014:

Do health-care professionals have the right to refuse to provide abortions or contraception based on their “conscientious objection” to these services? Many pro-choice activists would retort, “No way! If you can’t do your job, quit and find another career!” We agree with them, and have detailed why in our new paper, “‘Dishonourable Disobedience’: Why Refusal to Treat In Reproductive Healthcare Is Not Conscientious Objection.”

Reproductive health care is the only field in medicine where freedom of conscience is accepted as an argument to limit a patient‘s right to a legal medical treatment. It is the only example where the otherwise accepted standard of evidence-based medicine is overruled by faith-based actions. We argue in our paper that the exercise of conscientious objection (CO) is a violation of medical ethics because it allows health-care professionals to abuse their position of trust and authority by imposing their personal beliefs on patients. Physicians have a monopoly on the practice of medicine, with patients completely reliant on them for essential health care. Moreover, doctors have chosen a profession that fulfills a public trust, making them duty-bound to provide care without discrimination. This makes CO an arrogant paternalism, with doctors exerting power over their dependent patients—a throwback to the obsolete era of “doctor knows best.”

Denial of care inevitably creates at least some degree of harm to patients, ranging from inconvenience, humiliation, and psychological stress to delays in care, unwanted pregnancy, increased medical risks, and death. Since reproductive health care is largely delivered to women, CO rises to the level of discrimination, undermining women’s self-determination and liberty. CO against providing abortions, in particular, is based on a denial of the overwhelming evidence and historical experience that have proven the harms of legal and other restrictions, a rejection of the human rights ethic that justifies the provision of safe and legal abortion to women, and a refusal to respect democratically decided laws. Allowing CO for abortion also ignores the global realities of poor access to services, pervasive stigma, and restrictive laws. It just restricts access even further, adding to the already serious abrogation of patients’ rights.

(Emphasis added.)

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Signal Boost: Kurt Eichenwald on “the Murderous Cruelty of Conservatives”

Vanity Fair published a column yesterday by Kurt Eichenwald entitled “My Family, Our Cancer, and the Murderous Cruelty of Conservatives,” in which he recounts his wife Theresa’s struggle with breast cancer, the top-shelf medical care she received, and the fact that many Americans have no chance at all of receiving remotely similar care. He lays this right where it belongs, at the feet of Republicans (and their occasional blue-dog Democratic allies), who refuse to support health care measures that nearly every nation in the industrialized world now takes for granted, and who refuse to acknowledge the impact their policies have. The whole article is excellent, but here are a few quotes that stuck out for me:

Many Republicans, either out of self-delusion or deceit, deny they are causing any such thing. But there is no question that, in their obsession with zygotes, embryos, and non-viable fetuses as part of their supposed pro-life stance, they are effectively murdering real, walking, talking women—mothers and daughters, grandmothers and sisters, all sacrificed on an altar of Pecksniffian hypocrisy and contemptible disregard by people who have the insurance, connections, and available health care to feel certain their politics won’t kill their loved ones. Perhaps Theresa and I are re-directing our anger from the cancer, but so be it; our rage has focused on the financially comfortable, morally blind, and arrogantly self-righteous who tyrannically conspire to rob poor women of years of life they might otherwise have. It is for this reason that Theresa is willing to disclose her condition, in hopes that, in doing so, we will help highlight how politicians are blithely choosing to kill women who are not as fortunate as she is.

And this:

Like a boy trying to justify what he wants to believe, rather than forming belief around demonstrable facts, the Texas legislators and their mostly G.O.P. counterparts around the country aren’t making arguments. They’re just saying things based on a woeful ignorance of the issues involved.

And this:

Since you don’t understand the issue beyond your desire to limit abortions, Rep. Laubenberg, let me put the meaning of what you have done in clear terms: through your ignorance or incompetence or general lack of interest in the well-being of people who don’t look like you or have your size bank account, you will be responsible for the deaths of untold numbers of Texas women. You, Rep. Laubenberg, will be a murderer, no different than some street punk who shoots up a liquor store. His weapon is a gun; yours, a smug satisfaction with your limited understanding of health policy. If Theresa and I were among the rural poor, she would now almost certainly be one the many people you would kill as a result of her inability to gain access to breast screenings. And for that, you deserve not only our contempt, but the contempt of every decent human being with the humility and intelligence to recognize the impact of the legislation you have “written,” yet aren’t bright enough to understand.

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The America I Know

1342516_29565745Today is a victory for many people, and a defeat for almost as many. The sun rose this morning and is still shining as I write these words, so clearly the more Biblical of the warnings we heard regarding this election have not come to pass.

Right now, we have no way of knowing what the broader lessons of the 2012 presidential election will be. I can certainly hope that the reelection of Barack Obama, as much as I may find fault with his presidency, is an affirmation of what I might call (in a secular sense) the better angels of our nature. Not everyone shares my beliefs and my views about what America is, what it can be, or what it should be, but I feel as though some of those views have been affirmed by the events of the past few weeks.

America, perhaps unlike any other nation in the world, is and always has been a work in progress. The American Revolution did not end with the Treaty of Paris in 1781, nor did the many conflicts within America end at Appomattox Courthouse in 1865. The American Revolution was not just a war fought with muskets. The United States of America is the revolution, and it continues to this day. Continue reading

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