When I get around to writing about the top ten controversies in bioethics that I see coming in this decade, near the top will be the struggle to enact conscience clauses to protect the careers of physicians, nurses, and other health care professionals who still take the Hippocratic Oath and its human exceptionalist values seriously. The other day, Massachusetts Attorney General Martha Coakley illustrated why such protections are, I believe, necessary. From the story:
How can a Massachusetts Senate candidate possibly offend 39 percent of voters in her state? If it’s Democrat Attorney General Martha Coakley, she would tell devout Catholics not to bother working in an emergency room (H/T Jim Hoft – Big Government). In the audio clip below, Ms. Coakley chokes on a question from radio host Ken Pittman referring to the conscience clause. Under the conscience clause, workers in health-care environments ranging from doctors to maintenance men can refuse to offer services, information, or advice to patients on issues like contraception, blood transfusions, etc..if the workers are morally against it. Here is how Ms. Coakley handled the matter. (audio and transcript below):
Ken Pittman: Right, if you are a Catholic, and believe what the Pope teaches that any form of birth control is a sin. ah you don’t want to do that.
Martha Coakley: No we have a separation of church and state Ken, lets be clear.
Ken Pittman: In the emergency room you still have your religious freedom.
Martha Coakley: (……uh, eh…um..) The law says that people are allowed to have that. You can have religious freedom but you probably shouldn’t work in the emergency room.
This statement is very broad and goes much farther than contraceptives and ERs. We have seen assertions–such as in the St. Louis Post Dispatch, that all such believers get out of medicine altogether.
If the time comes that people who believe in traditional medical ethics and the sanctity of human life are not welcome in health care–except perhaps in podiatry–not only will it be a profound injustice but the most vulnerable patients will suffer. Conscience clauses are becoming an increasingly urgent concern. Here is the link to a long piece I wrote for First Things explaining, among other things, what and who I think conscience clauses should protect, and why.
January 16th, 2010 | 11:26 am
This at first may seem a little off topic, but it’s not…
Advances in science… emerged, not from science in isolation, but from a culture that made science possible and that directed the fruits of scientific work toward good and compassionate goals. The culture from which science has emerged is Judeo-Christian culture, and modern science has arisen only in Judeo-Christian culture. Why has science been so closely linked to this specific culture? …
…The application of science to care for the sick presupposes the view that we have an ethical obligation to help the weakest among us. The atheist view of metaphysics — that the universe has no purpose and no designer and no transcendent ethical code — provides no impetus to scientific inquiry or to the compassionate application of scientific knowledge. Modern science arose in Judeo-Christian culture — a milieu of faith and prayer. It arose from Judeo-Christian culture — and nowhere else — for a reason….
…Judeo-Christian culture is indispensable to medical science. Yet there is a modern militant atheist movement that seeks to idolize science and that preaches hatred of Christian values and faith….
Cancer Research, Prayer, and St. Jude
http://tinyurl.com/y8exvpv
January 16th, 2010 | 11:33 am
Yeah… religious freedom, as long as you keep it to yourself I guess.
January 16th, 2010 | 11:48 am
Actually, banning people who object to certain (not all) procedures, such as administering Plan B, from practicing medicine is an efficient way of eliminating the intellectually insufficient from practicing.
If people believe that eating bread from Kraft and drinking sugar water will turn into the blood and skin of an ancient man, who we don’t know with certainty even existed, maybe they aren’t the best candidates to be working with life and death decisions on the overweight bodies of the public.
This would be a good thing for society.
Further, if we are concerned about physically disabled and handicapped people (doubtful if we are), it is up to US to decide to protect them through OUR legal system – not leave it up to the whims of a religious mythologist who also practices medicine.
Clearly people who believe in the sanctity of human life are not welcome in the Republican party – otherwise I would hear more outrage over Blackwater and the constant war lust for blood that Republicans seems to have. Then, of course, you get the Republican chicken hawks, little men like Billy Kristol who inherited daddy’s publishing company, who not only can’t accurately predict how long and how much the war would cost, but actually revel in it. Instead, de facto Republican leaders seem more interested in blaming the devil for devastating earthquakes (them dark skinned people deezurved it!) or using the radio to chastise our “Magic Negro” president for helping.
How dare liberals legislate that health care actually address patients’ needs and concerns! Evil. Evil. Evil.
Wesley J. Smith Reply:
January 16th, 2010 at 4:02 pm
Keep it up David. You are a great example.
January 16th, 2010 | 1:14 pm
Social comments and analytics for this post…
This post was mentioned on Twitter by MLAS: RT @CO2HOG Devout Catholics Not Welcome in Emergency Rooms? http://bit.ly/6Auch9 #MAsen #tcot…
January 16th, 2010 | 3:34 pm
This is the kind of thing that really makes me angry. It turns the US into a police state by the state imposing it’s beliefs on health care workers-they’ve already demolished Catholic Charities in MA because it would no longer place children with gay couples, now we’re supposed to squash all religious health workers too? It makes me sick.
January 16th, 2010 | 4:24 pm
Is there a question Coakley HASN’T choked on?
January 16th, 2010 | 5:08 pm
David,
Again, it seems that you are so determined on bloviating your hackneyed opinion that you declined to actually read the article that I posted the link to.
You should try reading them, before you bloviate.
Without our Judeo-Christian culture, you may have never even been born.
January 16th, 2010 | 11:32 pm
Fine, David. Shut down all Catholic hospitals and forget anyone who has ever been helped by them. You know who are especially bad, those #$*! Connecticut Catholics with their safe affordable housing and mobile clinics. Good riddance.
And while you’re at it, explain why our Democrat president wants an additional $33 billion for war in Afghanistan.
http://www.washingtonpost.com/wp-dyn/content/article/2010/01/13/AR2010011300465.html?hpid=sec-politics
January 17th, 2010 | 11:45 am
Here’s part of the interview that Jim Hoft buried, typically:
PITTMAN: Right, if you are a Catholic, and you believe what the Pope teaches, you know, that any form of birth control is a sin. And you don’t want to do that, that –
COAKLEY: No, but we have a separation of church and state here, Ken, let’s be clear.
PITTMAN: Yeah, but in the emergency room you still have your religious freedom.
COAKLEY: The law says that people are allowed to have that. And so, then, if you — you can have religious freedom, you probably shouldn’t work in the emergency room.
PITTMAN: Wow. OK, so if you have religious conviction, stay out of the emergency room.
COAKLEY: Well, no, I’m not — look, you’re — you’re the one who brought the question up. I don’t believe that the law allows for that, and I know that we accommodate all kinds of differences all the time. I think Roe vs. Wade has made it clear that women have a right to choose, and in Massachusetts, particularly if someone has been the victim of a rape, an assault, and she goes to an emergency room to get contraception, someone else should say, “Oh, no, I don’t believe in this, so I’m going to affect your constitutional rights?”
PITTMAN: I agree that you’ve gotta have some balance there.
If a rape victim shows up at an emergency room to receive legal treatment, can an hospital deny legal treatment because of an employee’s religious beliefs? Clearly special accomodations must be made for the employee’s religious beliefs, including hiring extra employees if it comes to that.
Wesley J. Smith Reply:
January 17th, 2010 at 11:57 am
Jeffrey: That changes it to some extent, I agree. It should have been included in the news report. Thanks.
January 17th, 2010 | 1:31 pm
Daniel,
Your first inclination was right – it was off topic.
I did read Egnor’s essay and came away unconvinced. The author’s thesis was that a Mr. D.Z. Meyers had written an article in the “vile” Pharyngula denigrating religious faith. Now Mr. Meyers may denigrate religious faith elsewhere but he didn’t in this article. In the 1200 word article here was the only sentence in Meyers’ article remotely referencing religious faith:
“If we want to cure adult cancers, like the melanoma that killed Karen, don’t look to magic, or wishful thinking, or ancient shamanistic wisdom, or prayer — we’ve had those for millennia, and they do nothing.”
and continuing:
“What we need is more research, more doctors, more clinical trials, and more money.”
Who would argue with that? And why?
I’m speculating, but to me Egner seemed to want to present his hypothesis that Judeo-Christian culture was the primary impetus for modern science and medicine. I was receptive to being convinced but Egner presented no evidence. Here’s the meat of his argument (actually assertions):
“The scientific investigation of nature using the scientific method depends on the metaphysical view that nature is rational and that natural laws can be discovered and used by human beings.” (This is a nonsensical assertion. He is saying the observation of nature depends on metaphysics, i.e., magical belief. The assumption that nature is rational is the definition of rational thought. Millenia of observation confirm this. All it takes to refute rationality is a single confirmed miracle or magical act. Reason is still waiting to be debunked.) “The Judeo-Christian understanding of God and of man’s relationship to God accords with these preconditions for successful science.” (That religious belief is not a priori inconsistent with science… OK.) “The application of science to care for the sick presupposes the view that we have an ethical obligation to help the weakest among us.” (This ethical obligation does not presuppose religion or a deity, though. Wild animals care for and defend the young and the weak. Altruism is not limited to Christians.) “The atheist view of metaphysics — that the universe has no purpose and no designer and no transcendent ethical code — provides no impetus to scientific inquiry or to the compassionate application of scientific knowledge.” (And yet atheists were and are ardent advocates of the scientific method, scientific research and exhibit compassionate behaviors.) “Modern science arose in Judeo-Christian culture — a milieu of faith and prayer.” (It arose coincident to the rise of the Judeo-Christian culture, not because of it. The Church has a checkered past regarding scientific issues. It can be argued that science evolved despite the Church, not because of it.) “It arose from Judeo-Christian culture — and nowhere else — for a reason.” (This is plainly false.)
January 17th, 2010 | 1:47 pm
Devout Catholics are certainly welcome in emergency rooms as long as they practice medicine there, and not religion. If an emergency physician in a secular hospital refuses to administer Plan B to a rape victim because his “conscience” tells him that rape victims ought to bear their attackers’ children, then he should be kicked out of that hospital so that he can go to work for some like-minded religious institution.
January 17th, 2010 | 2:03 pm
Daniel: Christianity has been one of the biggest opponents of science ever since the church had it out with Galileo about the geocentric universe. A remark like “[m]odern science arose in Judeo-Christian culture — a milieu of faith and prayer. It arose from Judeo-Christian culture — and nowhere else” tells me you don’t know where we got our numbering system, algebra and astronomy from (Arabia), the mathematical concept of “zero” (India) or rocketry (China). On the other hand, 19th century English Christian apologists argued that women in childbirth should not receive anesthesia because God decreed that they should “bring forth children in pain and sorrow.” Are you sure you haven’t been reading too much David Barton?
Wesley J. Smith Reply:
January 17th, 2010 at 7:06 pm
Actually, some of the strongest early opponents of anesthesia were doctors. Read, The Worst of All Evils: The Fight Against Pain, by Thomas Dormandy. It has a fascinating account of the development of anesthesia. Here’s my book review: http://www.firstthings.com/article/2007/03/deadening-pain-4
January 17th, 2010 | 5:13 pm
David the troll needs a hug, and then some advice about focusing his thoughts. Speaking of intellectually insufficient…interesting David always needs to conflate Christianity with the Republican party. Newsflash: Not everyone is so myopic as yourself that they sell their intellect to conform to a party’s platform. I’ll bet that most people are sick of having to vote for candidates that can’t think for themselves but just regurgitate the party line.
By her own words, Coakley represents a clear threat to one of the most basic and cherished rights – freedom OF religion. This basic right was recognized by our founding fathers not as a concession of the state, but a fundamental right inherent to all of humanity. When the state beings to infringe on this right, it beings to don the fleece of totalitarianism.
January 17th, 2010 | 7:55 pm
HW,
First: “choice” goes both ways (or should), you know.
Second: if they work in a secular hospital, there should have no problem finding someone else on the staff who doesn’t care. Are you really telling me that you would just fire someone highly qualified to save lives because they had ethical reasons not to administer Plan B? I begin to suspect this is not about standards of practicing medicine, but about sticking it to somebody. Spiritual rape, if you will.
January 18th, 2010 | 1:45 pm
Spiritual rape? Hey, that’s a new one. Is that how members of the clergy do it?
Seriously, if you’re going to allow a conscience objection then you can’t object to an MD who’s also a shaman shaking his rattles over an accident victim while he bleeds out. After all, his sincere belief that “the Great Spirit will take care ….” ought to be sufficient, right?
Whether standard medical procedure requires a physician to take a particular series of steps to treat someone who’s bleeding to death (such as check breathing and maintain an airway before doing anything else), or whether it requires that a rape victim be told about Plan B and given it if she requests, it’s the doctor’s responsibility to follow the procedures, not contemplate their philosophical ramifications. I’m not talking about so-called “reasonable accommodation” such as when a Sikh cardiologist is permitted to wear an oversized head covering in the OR so he doesn’t have to remove his turban. I’m talking about “accommodations” that will affect the actual practice of medicine.
So yes, I would fire any doctor no matter how “talented” who thinks he can practice medicine any way he likes and then hide behind a conscience clause. For that matter I’d fire any doctor who refused to follow a hospital’s protocols for ANY reason, just as I would fire an employee who didn’t follow company policies or failed to do the job he was trained to do.
Any doctor who thinks his conscience entitles him to treat a patient in a non-standard manner in order to appease his own conscience should be in some other profession.
January 18th, 2010 | 1:51 pm
HW doesn’t believe in “choice” unless it involves a mangled fetus, per his comments regarding families who attempt to continue treatment for sick children in the face of futile care impositions and conscience legislation.
January 18th, 2010 | 5:33 pm
Safepres: Of course I believe in the right to avoid abortion, as well as the right to keep an insensate patient “alive” indefinitely with tubes running in and out of his/her orifices. I assume, however, that you’re the one who will be paying the bills, not I. Otherwise you ought to be minding your own business. Now with respect to doctors, when I go into a hospital I expect the doctor’s going to treat me in the standard way, and not as his conscience strikes him, or how his priest says it ought to be, or how the National Right to Life Committee suggests, or however makes him feel warm and fuzzy. Dostors may be professionals, but professions have standards and to the extent that a doctor doesn’t adhere to them he’s putting both his patient and his practice at risk.
Take the case of the rape victim and Plan B. Suppose Dr. X is unable to find another doctor who’s willing to prescribe Plan B? Should he then release the patient without doing so? And if the victim has been impregnated shouldn’t she sue the doctor for malpractice? If you were on a jury would you support the doctor or the patient?
January 18th, 2010 | 5:47 pm
Well, I’m not sure, HW, all the information I’ve read on the morning after (Plan B) pill indicates that it works if taken within three days of intercourse. Thus, as long as the rape victim is able to access EC within three days, her rights will remain intact. Moreover, you are functioning on a very shaky “What if” scenario that would likely NEVER happen, especially in a “blue” state like MA.
Moreover, it sickens me that you demand that everyone pay more taxes to support the poor but you balk at paying more taxes to support medically dependent individuals. Your refusal to support the choice to continue treatment, even that choice based on your tax dollars, is hypocritical.
January 18th, 2010 | 10:24 pm
David wrote: “Clearly people who believe in the sanctity of human life are not welcome in the Republican party – otherwise I would hear more outrage over Blackwater and the constant war lust for blood that Republicans seems to have.”
How does taking care of the terminally ill compare with waging war on terrorists? The terminally ill are non-combatants; terrorists are murderers who target civilians. These are two very different issues. You are clearly comparing apples with oranges, and that is
non–sequitur.
HHH
January 18th, 2010 | 11:24 pm
“Seriously, if you’re going to allow a conscience objection then you can’t object to an MD who’s also a shaman shaking his rattles over an accident victim while he bleeds out.”
Okay, this is simply silly. Not everybody on this planet shares your contempt for organized religion, HW. Are you really willing to drive devout physicians out of practice and risk having hospitals affiliated with religious orders close rather than be forced to perform procedures they think are wrong? The Catholic church is on record as preferring to close their hospitals, which are something like 15% of the hospitals in the USA, rather than have them compelled to perform abortions.
Is your rigid ideological purity really worth that result?
January 19th, 2010 | 6:42 am
The Catholic Church has been throwing around those kinds of empty threats for years. Remember “give us public funds to run our religious schools or else we’ll close them and then the public school system will be overwhelmed.” Well, guess what? There are still Catholic schools out there. So now you know how seriously I take that argument. Let them close if they want.
January 19th, 2010 | 12:59 pm
All I can say, HW, is a hope that no ideological fascists like you get control of our government, or we are all in big trouble.
January 19th, 2010 | 6:38 pm
Safepres: What’s an “ideological fascist?” Anyone with whom you disagree? Someone who debunks religion as a policy-making tool? Somebody who’d laugh in your bishop’s face if he made a dumb threat like “We’ll close down our [fill in the missing facility] if you don’t do things my way?” Catholics can do whatever they like in their own hospitals, and I’m sure people who patronize them don’t worry about having abortions there. On the other hand, Catholic OB-GYNs in secular hospitals can either do what they’re told and follow standard operating procedures, or take up some other, less conscience-bound specialty — say, proctology.
January 20th, 2010 | 9:55 pm
“Safepres: What’s an “ideological fascist?” Anyone with whom you disagree?” LOL. Look in the mirror much?
January 21st, 2010 | 11:43 am
Safepres: For someone who claims to believe in human exceptionalism and supporting the severely handicapped with our tax dollars you seem awfully cavalier about writing off the 30-40 million Americans who are totally without health insurance. Would you prefer that they used the ER/HMO method, or went bankrupt in the event of illness? That they should stop being fruitful and multiplying? What DO you believe? You see, it seems to defy rational understanding, and IMHO your decision-making seems to be driven by religious ideology rather than by a clear-headed analysis of the issues.
Of course in a free society everyone has the right to believe in whatever collection of fairy tales he or she wants; they just shouldn’t expect to be taken seriously by anyone with an 85+ IQ
January 21st, 2010 | 12:16 pm
Safepres: Yes, I do look in the mirror — when examining my strikingly handsome face and phenomenal physique. ;-)
But you still haven’t answered the question: what’s an “ideological fascist.” Emotionally disturbed people sometimes invent nonsense terms to vent their frustrations, but I don’t think you’re in that category. Of course I could be wrong…
January 22nd, 2010 | 11:22 pm
HW-I do care about people without health insurance. You’re asking what I believe. I don’t know if you’re sincere or not, bu here I go: Politically, I am a moderate. That means that I am pro life/against abortion and support gay rights. I don’t like the current plan the Democrats are advancing but I am not against a public option on principle. If we can avoid rationing, than I support health care reform, including a public option. I am against the wars in Iraq and Afghanistan but I don’t think that our country executed said wars with evil motives, indeed, I simply don’t know enough about what’s been happening to say whether or not the US was “right” to do what it did. I care about the environment but I don’t like the way green ideology has manifested itself of late. I am a Christian but I do not feel that any of my social positions are dependent on my faith. My faith is consistent with my political views, but I would hold the same views if I were a Buddhist or an Atheist.
January 23rd, 2010 | 11:43 am
safepres: Thanks for being so candid.
About me, I consider myself to be a moderate as well [no laughing please], and an incurable freethinker. I’m liberal on pro-choice issues and support FOCA, but conservative on so-called “marriage equality.” Otherwise I’m opposed to discrimination against GLBTs. I also support anti-hate crime legislation.
I’ve supported affirmative action in the past, but believe that after nearly 50 years we should be reassessing the “numbers game” it’s become. I have undying respect for the rule of law over and above the moral claims of majority rule. And I oppose so-called “political correctness” which, rightly or wrongly, causes me to look like a heartless SOB at times(the legal education may contribute to that as well).
I’m a Democrat, and I think we have the best government money can buy — literally.
I’m a fan of Thomas Jefferson’s, and fiercely opposed to legislating morality or using public funds to support organized religion. I’m nominally Unitarian, but in reality a lapsed atheist. As an undergraduate I studied Classical Literature and the histories and religions of Egypt, Mesopotamia, Greece and Rome. I know too much about religious history, which is why I’m unable to tolerate the mixture of government and religion. ANY religion.
I am, indeed, a history writer, albeit of my local area’s history during the Victorian era. I have one full length book in its second printing, another that’s 3 chapters short of completion, and six or seven smaller publications. Sorry, but I won’t give out the ISBNs since that would make it possible to identify me.
In my spare time I teach, play music and post messages to Second Hand Smoke — the latter because I think Wesley’s essentially fair-minded even though I disagree with him on a lot of things.
My legal education was conducted in the old-fashioned Socratic manner (Wesley will know what I mean), so if I reply to questions with other questions, in a gadfly-ish style, it’s because that’s the way my teachers taught me to explore the ramifications of other people’s statements. I regret any annoyance this may have caused in the past, and apologize in advance for any it may cause in the future. And that’s about it.
HW
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