One expects to throw shoes at the TV during the elections, when loads of trivia pretends to be discussions of substance, but either we are in the silly season, or the press is unable to google and ignores history.

What got me on this tirade was the articles on the Bush’s administration’s “eleventh hour” regulations protecting the consciences of health care workers.

Uh, fellahs, the government has had these laws in place since the 1970’s.This is not a “new” rule, just the government restating the law and implementing regulations that check the rules are being followed.

Back then, there was a lot of abuse to those of us who refused to do abortions: I was failed in Obstetrics (and had it reversed on appeal) and my best friend was threatened to be thrown out of her residency if she didn’t do abortions (She appealed and lost, because the hospital falsely claimed Hindus allowed abortion; her fellow residents, all Muslim, won the appeal even though eugenic abortions are allowed in some varieties of Islam).

However, back then, the nurses etc. were given mandatory retraining to change their mind; for some it didn’t change their mind, so they were reposted elsewhere.

However, doctors soon realized doing abortions not only was an unpleasant thing to do (tiny body parts and all that) but that they lost business.So except for aging activists, most obstetricians got out of the abortion business, except for the occasional abortion on their regular patients for eugenic (retardation, deformity of the baby) or health reasons (young mother, high blood pressure, diabetes, heart disease).

As a Catholic, I won’t do abortions, but the dirty little secret in the “abortion wars” is that most people feel abortion is taking a life, but sometimes, like war or self defense, taking a life is justified. Even then, it is often mourned by the mom and regretted by the family.

One result of all of this is that abortion clinics started doing most abortions outpatient, so the “conscience” problem disappeared.

But more recently came the problem of the morning after pill.

In the past, it was believed that this worked by stopping ovulation; more recent work revealed it aborted an early pregnancy. As a result, Catholic hospitals stopped giving it out to rape victims…and the result is state laws mandating that they do it.

Again, usually women are taken elsewhere after rape. But what do you do when you have a woman desiring a “morning after pill” for convenience?  This is being promoted, even though statistically it does not decrease the rate of abortion (too often the woman takes it carelessly or too late,  and it doesn’t work, or doesn’t take it because it causes her to throw up), and there is the danger that a woman won’t use other forms of protection in cases of casual sex, meaning more cases of STD.

But some pharmacists are saying no to giving out this abortifactant pill … and not just Christian pharmacists, but some Muslim pharmacists.

So go to a different pharmacy, big deal.

Doctors have always had ethical reasons to refuse to harm patients.

In “reproductive” technology, this would include deciding if you wanted to do “test tube babies”, and even decide if you thought the couple involved should be given this treatment. Perhaps the couple has a genetic trait, and you advise adoption rather than transmitting the trait (this happened with a friend of mine). Perhaps after counseling, you recognize that there are issued with the couple that need to be worked out before the procedure is done (often men “agree” to using donor sperm, but emotionally they feel hurt and the marriage ends up in divorce). Some doctors refuse to give sperm to single women or lesbian couples, for fear of the children being brought up in an unstable home. (As a single mom I adopted, but I have friends who wanted children who chose artificial insemination; some were gay, some hetero but couldn’t find a suitable partner). Again, this is a moral decision, and often has other dimensions (drug use, promiscuity) beside “homophobia” or “morality” behind the decision.

The problem with “reproductive rights” is that no one is discussing reproductive responsibility.

This comes down to the question: if physicians are to be gatekeepers in treatment, according to their best judgement, or merely “health care providers” that give out health care to anyone asking for any treatment?

This goes way past “reproductive rights”, as any doctor who has had people who they never saw before insisting you give them narcotics, or stimulants, after a single visit and without verifying the need, or patients who insist on elective surgery when other treatments (e.g. physical therapy for back pain) work better.

But what is not being discussed is that the reason behind the Bush administration’s restatement of the 1970’s rules is that hospitals, clinics, and doctor’s offices have changed from the small private business model to the Big Business model, along with the big business ethic.

So a private pharmacy, or a doctor in private practice, could refuse to do procedures, but what about if they work for a big chain store or a large HMO?

Again, the rules is that the patient be given to another health care worker for the agreed to services.

Ah ha: This costs the big businesses money. Easier to harass employees than try to hire someone who agrees to do the procedure.

Then there are hospitals. Many small hospitals have merged, and often this included a merger with a Catholic hospital, where the merger agreement said that the merged hospital would not do procedures that are forbidden for Catholics.

Again, for patients a minor inconvenience.

But for those promoting reproductive rights, a major emotional problem.

You see, this is emotional, not logical. Often there is rage against anyone who even hints that abortion is wrong, or should have limitations. Abortion leaves a hurt in those who were forced into the procedure (and in most cases, the woman literally is given no choice in the matter by her family or consort).

Caught in the middle? The many health care professionals at all levels of medicine and nursing who went into the profession to save life, not to take it.

So the kerfluffle is not Bush promoting the laws of the far right religious types, but merely reminding these clinics of the law protecting the rights of their workers. Nor is it “11th hour” regulations (such regulations take years to devise in the slow bureaurocracy).

My take?

It is a reminder of the law for when Obama decides to nationalize all health care, and/or a reminder of the rights of health care personnel in the face of big business take over of health care.

And in the future, when euthanasia will be pushed as compassion (when the real reason is that it will save money) such laws will be even more needed.

But that’s another discussion altogether.


Nancy Reyes is a retired physician living in the rural Philippines. She writes about medical issues at HeyDoc Xanga Blog

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