The Los Angeles Times has a piece up this morning entitled Broader medical refusal rule may go far beyond abortion. The subheader for the piece is The Bush administration plans a new ‘right of conscience’ rule that would allow more workers to refuse more procedures. Critics say it could apply to artificial insemination and birth control. From the piece:

The outgoing Bush administration is planning to announce a broad new ‘right of conscience’ rule permitting medical facilities, doctors, nurses, pharmacists and other healthcare workers to refuse to participate in any procedure they find morally objectionable, including abortion and possibly even artificial insemination and birth control.

For more than 30 years, federal law has dictated that doctors and nurses may refuse to perform abortions. The new rule would go further by making clear that healthcare workers also may refuse to provide information or advice to patients who might want an abortion.

It also seeks to cover more employees. For example, in addition to a surgeon and a nurse in an operating room, the rule would extend to “an employee whose task it is to clean the instruments,” the draft rule said.

…Health and Human Services Department officials said the rule would apply to “any entity” that receives federal funds. It estimated 584,000 entities could be covered, including 4,800 hospitals, 234,000 doctor’s offices and 58,000 pharmacies.

Not mentioned is that transsexuals like me might have difficulties receiving hormone prescriptions, or filling hormone prescriptions because of the religious convictions of providers.

The August press release on the new rules is here; the proposed rules are here.

These new rules are strongly supported by the Christian Medical Association (CMA) and the U.S. Conference of Catholic Bishops. From the July CMA press release calling for ‘right of conscience’ regulations:

[Below the fold: CMA and AHA comment on the proposed 'right of conscience' regulations.]

“It’s high time that the will of the people, as expressed over the past 35 years through laws passed by Congress, finally be translated into practical healthcare regulations,” noted Dr. David Stevens, CEO of the 13,000-member faith-based professional organization of doctors, in a letter today to the Secretary.

“Americans on all sides of controversial issues such as abortion, reproductive technologies and assisted suicide can appreciate the need to protect everyone’s First Amendment rights of free speech and religious exercise. That means that healthcare professionals must be free to follow their individual conscientious convictions on these life-and-death matters.

…Dr. Gene Rudd, Executive Vice President of the CMA, noted…”The regulations reportedly under consideration at Health and Human Services apparently would simply protect the right for all healthcare professionals to make professional judgments based on moral convictions and ethical standards. Protecting this right also protects patients who choose their physicians based on life-affirming values.”

It doesn’t protect those of us who don’t pick our physicians base on these “Christian” values, especially because even if we pick a physician based on our values, it doesn’t protect those of us who receive objectionable services from the nurses, medical technicians, and staff of our chosen physician, nor does it protect us from pharmacist technicians, pharmacist staff, and pharmacists themselves.

The American Medical Association (AMA) and the American Hospital Association (AHA) have come out against these regulations. From the AHA letter on the proposed regulation change:

The definitions of “health care service program” and “health care service,” to which an individual can find a moral objection, are very broad and potentially impinge on a patient’s access to needed health care services. The preamble states that “health care service program” should be understood to include any activity related in any way to providing medicine, health care, or any other service related to health or wellness, and that “health care service” means any service so provided.

The preamble also defines, very broadly, the types of individuals that may be involved in an objectionable procedure. The preamble provides an example of a health care worker who autoclaves (sterilizes) surgical instruments used in an objectionable procedure as someone that “assists in the performance” and is thereby protected under the provider conscience clause. The preamble language further defines that any activity with a reasonable connection to the objectionable procedure, such as referrals and training, can also be considered objectionable. This broad definition of “assist in the performance” suggests that any individual invoking the conscience clause protections is under no obligation to refer the patient to other practitioners, pharmacists or hospitals from whom the patient could receive care. The AHA objects to any proposal that releases a practitioner, for any reason, from an obligation to provide or assist patients with a referral or other information that would allow the patient to receive needed health care services.

The definitions for objectionable health care services and individuals that assist in objectionable procedures is so broad that hospitals have no reasonable way of planning to ensure that patients have access to the health care services they need. Hospitals and their emergency departments are complex entities; as the proposed rule is written, it would be extremely difficult for hospitals to anticipate all the scenarios under which a health care worker might invoke the provider conscience clause. As a result it would be impossible for hospitals to make the staffing arrangements needed to ensure access to those services. The AHA is concerned that access to services for patients may be significantly hampered by the current definitions of this rule.

This is quite a Bush Administration present for “Christian” and other social conservatives at the expense of patients — patients like me.