Obama ready to undo Bush medical conscience clause

March 2, 2009

Should health care workers such as doctors, nurses, and pharmacists be able to avoid their otherwise expected duties when they have religious objections? The Obama administration has stepped into this urgent question. A Bush administration regulation from its last days did award this sort of medical exemption from duties. Many religious organizations and religiously based health care facilities had desired this rule for decades, since the Roe v. Wade abortion decision. As the New York Times reports on the Bush regulation,

"The rule prohibits recipients of federal money from discriminating against doctors, nurses and other health care workers who refuse to perform or assist in abortions or sterilization procedures because of their ‘religious beliefs or moral convictions’.” Article by David Stout,   "Obama Set to Undo ‘Conscience’ Rule for Health Workers" in the New York Times . Also see   another article in the Washington Post .

Action against the Bush rule had already been undertaken by several states and privacy rights organizations. As reported in   an article at The Consumerist , seven state attorneys general, Planned Parenthood, and the ACLU sued to prevent enforcement.

Ever since Roe v. Wade, many religious health care providers have sought a legal way to avoid having anything to do with abortions, artificial reproduction like IVF, birth control, and other ethically contoversial matters like removing life support. They portrayed their cause as a fight for a basic democratic right, the right to be a "conscientious objector" to such procedures.

Exemptions from professional service and legal requirement are necessary to preserve the still more fundamental civil right to religious liberty. But is this issue just a conflict between ordinary government concerns and extraordinary civil right protections? If this is the best way to depict this issue, then the resolution may seem simple; indeed, probably too simple. There is a long legal history, in the United States and several other countries, of carving out special exemptions from legal requirements in order to protect individual religious liberties. In the conflict between crucial constitutionally protected civil rights and important governmental interests in personal and social welfare, it appears more justifiable, in many cases, to create an exemption for the individual’s civil rights. For example, the term “conscientious objector” originated in the debate over whether individuals should be compelled to perform military service despite their religious objection to personally participating in military activity.

If the desire for conscientious objection exemptions on the part of health care professionals is best framed as roughly analogous to the desire for religious exemptions to military service, then the case for these medical exemptions can be considerably strengthened. Perhaps exemptions for health care providers are best understood simply as gradually expanded applications of the principle that sincere religious objections to professional duty should prevail over important government interests.

The Obama administration apparently disagrees. And there are some good reasons. Watch this blog for more commentary on this important debate over civil liberties.



#1 Personal Failure (Guest) on Monday March 02, 2009 at 1:55pm

What shapes my opinion on the subject is my grandfather’s stories of the Quakers’ military service during WWII: they served as unarmed medical personnel, running out onto the battlefield to retrieve wounded soldiers, without any way of defending themselves.

They did not shirk military service, they simply did what their beliefs would allow, and did it bravely. If you have a religious objection to birth control or abortion or sterilization or IVF, but still wish to be a medical professional, the answer is clear: choose a portion of the medical field or a provider that doesn’t involve those actions. There are plenty. (I would imagine plastic surgeons rarely have to give abortions.)

Otherwise, you’re just deliberately trying to push your religion up my [censored].

(If my grandfather was making up or conflating stories, I’d appreciate not knowing about that. Listening to those stories are about the only memories I have of him, and I’d like to keep them intact. Thanks.)

#2 Alex (Guest) on Monday March 02, 2009 at 3:00pm

There are two dimensions to this debate. One is that of individual employees, such as doctors, nurses, pharmacists, aides, etc. and whether they have a broad right to refuse to participate in actions that violate their moral beliefs. The law (the Civil Rights Act of 1964) is fairly clear on this and protects such employees as long as their objections can be easily accommodated by the employer. For example, if an assistant in a hospital does not want to sterilize and prepare instruments to be used in an abortion, her objection must be accommodated if possible (for example, by assigning another available worker to the task). But in situations in which employers are unable to accommodate an employee’s religious beliefs easily (for example if the employer of an Orthodox Jew would have to hire someone else to work on Friday nights), they have the right to fire the employee. On this question, the HHS regulations are redundant at best (and quite unclear).

The second question is whether religious institutions that are health care providers (e.g. Catholic hospitals) can be required to provide services they object to. That’s a much more difficult problem in which only one thing seems certain - that it should be dealt with at the state level. And even ignoring this, the HHS regulation is discriminatory in that it only protects objections to abortion and sterilization.

Obama is right to undo the rule, but the debate is far from over.

#3 Guest (Guest) on Thursday March 12, 2009 at 4:57am

Any new updates on this. I am unable to find it on the white house page.

#4 Urgent Medical Care (Guest) on Wednesday March 18, 2009 at 1:07am

This is a nice article discussed about medical Conscience but have no update material ... from where i found it.

#5 Adam-Victoria Mortgage Brokers (Guest) on Thursday March 19, 2009 at 10:11pm

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#6 Shanky -Connecticut personal injury lawyer (Guest) on Friday March 20, 2009 at 11:55pm

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