"Provider Conscience" Provisions Won't End With Bush Presidency

Though Obama is considering a repeal of Bush-era regulations that allow health care providers to refuse to give treatment that conflicts with their beliefs, most states have older laws that still safeguard "provider conscience."

A survey for the Christian Medical Association found that 90% of providers would "quit their practices before violating their conscience." But even if this statistic is accurate, we're unlikely to see a mass exodus of doctors. After Roe V. Wade, many state laws and some federal laws were enacted to protect doctors and other health care workers from having to carry out abortions. Some laws are broad enough to allow doctors to exempt themselves from performing sterilization or in vitro fertilization, or from prescribing emergency contraception.

Joxel Garcia, Bush's assistant secretary for health, says we need the newer, Bush-era laws on top of these older laws because doctors aren't aware of the older ones (apparently the thought that if you're going to refuse to perform a medical procedure, you might at least be responsible for checking whether you're legally protected, has not occurred to Garcia). He adds that, as a med student in the late 80s, he was advised not to apply to certain ob-gyn residencies if he wouldn't perform abortions. The fact that some ob-gyn programs might want to train doctors who will offer women the full range of medical services encompassed by their specialty isn't particularly surprising — except in light of Medical Students for Choice member Rozalyn Farmer Love's account of having to hide her pro-choice views for fear of discrimination by professors. Anti-abortion doctors aren't the only ones whose convictions are under fire.

Bioethicist Nancy Berlinger says,

Words like belief, when you talk about them in the context of health care, aren't just anything you might think of. They have to be defensible. And a false belief about science or the promotion of ambiguity where things can be disambiguated is not ethical.

Berlinger's words are a reminder that there are limits to how much a doctor's beliefs can affect his or her practice. A Christian scientist physician cannot refuse a cancer patient chemo — is it really reasonable to allow a gynecologist to refuse a woman a legal abortion? What about to refuse IVF? The Pill? The more "conscience provisions" an aspiring ob-gyn needs, the more sensible it seems for him or her to consider a different specialty. The solution is certainly not to maintain several separate sets of laws that allow doctors to deny women care.

Some Docs Resist Repeal Of Bush-Era Abortion Regs [NPR]