Sunday, July 16, 2006

Unconscionable Interference

In response to this:
Around the United States, health workers and patients are clashing when providers balk at giving care that they feel violates their beliefs, sparking an intense, complex and often bitter debate over religious freedom vs. patients' rights.

Legal and political battles have followed. Patients are suing and filing complaints after being spurned. Workers are charging religious discrimination after being disciplined or fired. Congress and more than a dozen states are considering laws to compel workers to provide care -- or, conversely, to shield them from punishment.

Proponents of a "right of conscience" for health workers argue that there is nothing more American than protecting citizens from being forced to violate their moral and religious values. Patient advocates and others point to a deep tradition in medicine of healers having an ethical and professional responsibility to put patients first.

The issue is driven by the rise in religious expression and its political prominence in the United States, and by medicine's push into controversial new areas. And it is likely to intensify as doctors start using embryonic stem cells to treat disease, as more states legalize physician-assisted suicide and as other wrenching issues emerge.

"What constitutes an ethical right of conscience in medicine, and what are the limits?" asked Nancy Berlinger of the Hastings Center, a bioethics think tank. "This keeps getting harder and harder for us." [WaPo]
I feel compelled to re-run part of a post of mine from October 2005:

Healthcare workers are required to put the health of the patient first, if they can not do that for all patients they may serve they need to either avoid working in places where the possibility of being involved in the care in cases they can not participate in or ensure there is always someone else working on their team at the same time to fulfill those tasks they can not. A nurse who is a Jehova's witness can not force someone to find another facility or come back at another time if they need a transfusion of blood products (even if the need for transfusion is not emergent), to do so would be refusing to follow the doctor's orders and interfering with the physician prescribed action plan (nurses who are Jehovah's witnesses have another person on staff who is working at the same time do the transfusion). The same goes for a pharmacist, to refuse to fill a valid and legal medical prescription when the medication is in stock (or lie to say it is not in stock) is interefering with the medical care of a patient. A pharmacist who is a Scientologist is not allowed to refuse filling legal and valid prescriptions to patients because use of particular types of medications are proscribed by Scientology as that would be an imposition of Scientologist's personal views on a non-adherent. Similarly, there is no legitimate reason to allow adherents of any other religion to allow their personal views to interfere with the medical treatment of a patient by an appropriately licensed healthcare practitioner.

Pharmacists who have moral issues with certain medications have multiple legitimate alternatives to prevent them from interfering in medical care while continue to work as a pharmacist including: working at a pharmacy that makes it clear they do not stock or fill prescriptions for [insert type or class of medication here]; working at a mail order/internet pharmacy wherehouse with an agreement they will not be involved in filling prescriptions for medications they find offensive/immoral (while not interfering with those medications or the dispensation of them by another), or ensuring there is always another person on staff with them at the same time who will fill and dispense those prescriptions. If the pharmacist feels that compliance with the latter two alternatives and/or referring the patient to another pharmacy after ensuring that pharmacy has someone on duty to fill the offending prescription in a timely fashion when his/her pharmacy really is out of stock would make him/her a party to the sin of using the offending medication, the pharmacist should refrain from working at a pharmacy that stocks those medications (s)he finds morally objectionable.

We do not force people into professions that may require them to perform tasks they find morally objectionable by way of legislation. For all intents and purposes, those who enter the profession of pharmacist choose their course of study and how to utilize their education of their own volition. The only reason a pharmacist would work in a setting in which (s)he may be the only person on duty permitted to fill a prescription their pharmacy stocks is to intentionally set him/herself up in a position by which (s)he can become a barrier to filling those presciptions. This isn't about rape, sex or abortion, this is about the intentional interferance with medical treatment in an effort to impose one's religion on others, and is a direct violation of the first amendment.
Additional examples of how the public has been affected by the religious zealotry impacting health care decisions can be found at

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