Conscience Schmoncience! Who cares what you believe?

hiddencatRN, BSN, RN · May 21, 2011

Not sure where this goes on allnurses. But since everyone has their own core beliefs that inform their nursing practice, I thought it would be interesting to more than just the political junkies.
Obama's Grave Assault on Medical Conscience Rights
by Kristan Hawkins
05/21/2011
During the past two years, Americans have seen the expansion of the federal government into sectors of their economy and personal life as never before. And earlier this year, the Obama administration quietly moved into a new area of American life, one of its most intimate, the patient-doctor relationship.
Like the Obama takeovers of the automobile industry, the banking industry and then the health care industry, the new conscience-rights assault is the administration's latest attempt to fundamentally change our nation as we know it.
In February, the Department of Health and Human Services (HHS) announced the rescission of most of the Bush administration’s 2008 conscience protections, removing the rights of doctors, pharmacists and other medical professionals to object to prescribing or dispensing known abortifacient drugs such as Plan B and ella. This rescission sends a clear signal to medical professionals nationwide—leave your conscience at the door, and if you morally object to a medical procedure or medication, then you should be in another business.
When Students for Life, Medical Students for Life and other pro-life medical groups wrote to HHS about the rescission, the agency defended its decision and cited the federal definition of abortion, arguing that abortion-causing drugs such as Plan B and ella are not covered under the definition of abortion, and therefore doctors do not have the right to refuse to prescribe or dispense these dangerous drugs. ...
Kristan Hawkins is Executive Director of Students for Life of America.

Dangerous drugs? Really?

Takeovers? She means the bailouts?

A doctor's or pharmacist's personal beliefs shouldn't factor in to whether women and girls have access to Plan B. This reminds me of that piece in The Onion, "New Law Requires Women to Name Baby, Paint Nursery Before Getting An Abortion." http://www.theonion.com/video/new-law-requires-women-to-name-baby-paint-nursery,14393/

The Onion article is satire, but really, what about those laws requiring women to view an ultrasound before getting an abortion? I'm sure there are health care providers who feel that law is a violation of their patient-provider relationship, but I bet CMDA isn't worried about THAT governmental interference.

GHGoonette, BSN, RN · May 21, 2011

I don't get this...a Government decision can force doctors to prescribe certain drugs? Just as a matter of interest, is the Government forced to provide full, comprehensive counseling and advice for women contemplating abortion? Every woman I've known who has deliberately had her baby aborted has been wracked with guilt afterwards - and I know some who had illegal abortions almost fifty years ago. They have never got over it.

SJerseygrle · May 21, 2011

As soon as equally conveinant alternatives are found to allow those of us with equal, but differently informed, conscience to receive the healthcare that we want and deserve. If you're the only pharmacist in a 50 miles radius, sorry, you don't get to pick and choose what medications you will and will not dispense. Hire help, or become a car salesman.

In theory, it would be nice to let each person decide what they will and won't do, there is often no alternative that is equally safe and close. I know plenty of nurses who think helping fat people recover from heart surgery is the same as giving an addict crack - enablement of bad bahavior. They go to work on peds or oncology. Mary Jane percriptions are legal in some states. If you're against it, work in maternity.

On the other hand, a friend I respect greatly is against abortion. That's why she doesn't work in ER/maternity.

This is the job.

Jehovah's witnesses shouldn't work in a blood bank. It's like a Hasidic Jew working as an EMT who won't treat anyone on his Friday-Saturday shift. Or a Scientologist working as a psychiatrist. If your conscience won't let you do the job, get a different job.

jmqphd · May 21, 2011

As soon as equally conveinant alternatives are found to allow those of us with equal, but differently informed, conscience to receive the healthcare that we want and deserve. If you're the only pharmacist in a 50 miles radius, sorry, you don't get to pick and choose what medications you will and will not dispense. Hire help, or become a car salesman.
In theory, it would be nice to let each person decide what they will and won't do, there is often no alternative that is equally safe and close. I know plenty of nurses who think helping fat people recover from heart surgery is the same as giving an addict crack - enablement of bad bahavior. They go to work on peds or oncology. Mary Jane percriptions are legal in some states. If you're against it, work in maternity.
On the other hand, a friend I respect greatly is against abortion. That's why she doesn't work in ER/maternity.
This is the job.
Jehovah's witnesses shouldn't work in a blood bank. It's like a Hasidic Jew working as an EMT who won't treat anyone on his Friday-Saturday shift. Or a Scientologist working as a psychiatrist. If your conscience won't let you do the job, get a different job.

I think most people with particular sensitivities will avoid situations that they know will put them in moral conflict. The problem with the abortifacients is that the federal rule effects every pharmacist. Every single dispensing pharmacists. So it is a bigger deal than the fact that I need to avoid jobs at Planned Parenthood. There are people who are devout Mormons, Roman Catholics, Evangelicals, Orthodox Jews and serious Muslims who are or would like to go to pharmacy school but are giving it second thoughts.

If the problem is a lack of pharmacists in a rural community (50 mile radius) are you helping pregnant teen-aged girls by driving one of them out of practice. 'Cause non-pregnant teenagers are going to need antibiotics, and elderly people are going to need their lisinopril, and the farmer who wrenched his back is going to need vicodin and flexeril, and so on.

Your hypothetical pregnant teenager probably makes the drive into town to the Walmart pretty frequently and doesn't feel put-upon because she has to make that trip to get ordinary things. Rite Aid has looked at that little rural community and determined they can't make money there. But an independent pharmacist has been there for a while. So, because 16 year old Suzie can't get her Plan B from that store, take that pharmacists license from him (serves him right! don't ya' know) and make all the old folks drive into town for their Aricept and Coreg. Now the farmer with the bad back has to load himself into his pick-up and drive 100 miles round trip to get pain relief.

Somehow, I don't think enforcing this rule makes medications more readily available to Americans. I think it does the opposite.

imintrouble, BSN, RN · May 21, 2011

As soon as equally conveinant alternatives are found to allow those of us with equal, but differently informed, conscience to receive the healthcare that we want and deserve. If you're the only pharmacist in a 50 miles radius, sorry, you don't get to pick and choose what medications you will and will not dispense. Hire help, or become a car salesman.
In theory, it would be nice to let each person decide what they will and won't do, there is often no alternative that is equally safe and close. I know plenty of nurses who think helping fat people recover from heart surgery is the same as giving an addict crack - enablement of bad bahavior. They go to work on peds or oncology. Mary Jane percriptions are legal in some states. If you're against it, work in maternity.
On the other hand, a friend I respect greatly is against abortion. That's why she doesn't work in ER/maternity.
This is the job.
Jehovah's witnesses shouldn't work in a blood bank. It's like a Hasidic Jew working as an EMT who won't treat anyone on his Friday-Saturday shift. Or a Scientologist working as a psychiatrist. If your conscience won't let you do the job, get a different job.

When we become a country where each individual cannot decide what they will or won't do, according to their faith, I want to be dead.

Also, I WANT that thinking, feeling, reasoning, conscientious person taking care of me, instead of the machine that simply does what they're told. Even if I don't agree with their beliefs, I respect that they have them, live by them, honor them. As far as I'm concerned having a line you won't cross makes you a better human being.

Freedom42 · May 21, 2011

Yes, I have my own core beliefs. One of them is being truthful, something sorely lacking in this editorial.

Like the Obama takeovers of the automobile industry, the banking industry and then the health care industry, the new conscience-rights assault is the administration's latest attempt to fundamentally change our nation as we know it.
In February, the Department of Health and Human Services (HHS) announced the rescission of most of the Bush administration's 2008 conscience protections, removing the rights of doctors, pharmacists and other medical professionals to object to prescribing or dispensing known abortifacient drugs such as Plan B and ella. This rescission sends a clear signal to medical professionals nationwide--leave your conscience at the door, and if you morally object to a medical procedure or medication, then you should be in another business.
When Students for Life, Medical Students for Life and other pro-life medical groups wrote to HHS about the rescission, the agency defended its decision and cited the federal definition of abortion, arguing that abortion-causing drugs such as Plan B and ella are not covered under the definition of abortion, and therefore doctors do not have the right to refuse to prescribe or dispense these dangerous drugs.]
Obama rescinded Bush administration rules that health care workers used to refuse to perform a wide variety of services, including caring for people with AIDS. This apparently violated their "conscience." The Obama rules still allow doctors and nurses to refuse to participate in abortion or sterilization and to file complaints if they believe their rights have been violated.
Plan B does not cause abortion. It prevents implantation.
The Obama administration has made no "attempt to destroy the sacred doctor-patient relationship." What the rule change did was ensure that patient rights are protected, regardless of the practitioner's personal beliefs.
I'm always baffled when people who are so sure of the correctness of their beliefs resort to misleading statements and half-truths to make their case.

emtb2rn, BSN, RN, EMT-B · May 21, 2011

The ruling, as i understand it, simply means docs have let pts know all available options. And not pick and choose what legal meds they will/won't dispense.

Ashkins529 · May 21, 2011

1. If I go to my Dr and we don't see eye to eye on some aspect of my treatment (ie I want Plan B and Dr wont prescribe due to moral convictions)(need blood transfusion and I want it) it is adiós Dr.. It is what is best for ME not him/her.

2. If Dr and I agree and he/she gives me a prescription then it is between my Dr and I. Not between me/Dr and the pharmacist nor the health insurance.

This reminds me 11 years ago I needed to have a hysterectomy. (age 29) I had been really sick for a few years. I went to a new Dr who said my uterus needed to come out. I was like "Yes finally a Dr who agrees with me". It took 3 months for the insurance to approve it because of my age. Regardless of the fact my quality of life sucked. I had already had 3 children with no plans on having anymore. It was their moral convictions to say a 29 year old is too young to lose her ability to have children permanently. Long story short, after the 3 months of fighting the insurance they finally relented to me having laparoscopy to prove. He did it, then cut me open and did what we had agreed on before. Ended up costing the insurance more money for 2 procedures.

merlee · May 21, 2011

Excuse me, GHG and some others - - not everyone regrets their decisons. I had an abortion in 1978 and have no regrets. NONE. Despite precautions, I got pregnant while married to an abuser. This was not a marriage to bring a child into - and this was MY decision. It took me more than a year to finally leave him, and I shudder to think what my life would have been if I had stayed or had the baby.

NO REGRETS. Eventually another marriage, and two kids.

Not everyone has regrets. Or needs therapy.

And everyone should be able to at least know what all their options are.

jmqphd · May 21, 2011

The ruling, as i understand it, simply means docs have let pts know all available options. And not pick and choose what legal meds they will/won't dispense.

In February, the Department of Health and Human Services (HHS) announced the rescission of most of the Bush administration's 2008 conscience protections, removing the rights of doctors, pharmacists and other medical professionals to object to prescribing or dispensing known abortifacient drugs such as Plan B and ella.

I think some people are setting up straw man arguments and then demolishing them. This is not about doctors/phamacists/nurse-practioners being forced to educate patients about their options. This is about health professionals being forced to prescribe these drugs and fill the prescriptions.

I've read about this new HHS policy in the newsletters my husband gets from various professional organizations and I believe the line above from the article in the original post is accurate.

hiddencatRN, BSN, RN · May 21, 2011

In February, the Department of Health and Human Services (HHS) announced the rescission of most of the Bush administration’s 2008 conscience protections, removing the rights of doctors, pharmacists and other medical professionals to object to prescribing or dispensing known abortifacient drugs such as Plan B and ella.
I think some people are setting up straw man arguments and then demolishing them. This is not about doctors/phamacists/nurse-practioners being forced to educate patients about their options. This is about health professionals being forced to prescribe these drugs and fill the prescriptions.
I've read about this new HHS policy in the newsletters my husband gets from various professional organizations and I believe the line above from the article in the original post is accurate.

You're quoting from a highly biased article. Plan B and Ella are not "known abortificants" . They prevent implantation.

I work in a pediatric er and our main clientele for Plan B are rape victims, not your Susie Sixteen who drives her car to Walmart.

The "straw man" you're unhappy about is the contradiction in the argument of people who cry conscience. Mandatory waiting periods, forced education and viewing of ultrasounds impinge upon the consciences of women seeking abortion as well as the healthcare providers who support their right to do so. I cannot take the arguments of those who want to refuse emergency contraception as matters of conscience until those same people campaign for the lifting of mandatory waiting periods, forced 'counseling' and the like. Until then this is an attempt to push a political agenda, nothing else.