This came across my desk earlier this week. I thought I would toss it around on this venue and see what sticks.

Reporting from Washington -- 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.

Art. 4 of the constitution is most commonly associated w/ a patient's right to an abortion. By the same galactic stretch of the imagination one could suggest that privacy between a physician and patient is equal to employer and employee. If a patient can confide in their physician and privately obtain an abortion, then an employee should be afforded the same considerations. The actual article in question is in reference to private papers and belongings, not benevolent universal healthcare, or imposing collective thought. Both arguments that stretch the intentions of a 200 year old legal document are baked. But, it is a slippery slope.

Even as an atheist, I would have to admit that individuals that take issue with aiding in what they perceive as immoral practices takes priority over what the State permits. Push the argument further and consider what the public reaction would be if the State decided to endorse Kevorkian practices, while trying to limit the payouts of entitlement programs such as SS and Medicare. Would HC employees be obligated by their current employment contracts to loosen their moral standings to appease the State? We are not talking about cops that think the speeding limit is too low and refuse to issue tickets. People who are religious tend to think that there is a higher authority, right? The State can attempt to impose its moral compass but that is not how we are really set up here.

That leads to the community, which decides morals and norms, etc. My best guess, is that this is non-issue. Worst-case scenario, you end up at a hospital where every staff member refuses to aid in the procedure, which leads me to think that the community has spoken. Most likely, federally funded hospitals will evolve to compensate for staff members that take issue. Otherwise effective staff members that refuse certain tasks could be shifted around, etc. If consistency of care is an issue, a new employee contract could include an agreement to provide such services.

I do not disagree that there is an obligation between HC staff and the patient. The question is whether or not the State can impose a moral system on its citizens. A patient's right to receive an abortion is at best a negative right. By that, the State is obligated to not produce a barrier to a patient receiving medical treatments. That is not the same as the State coercing one citizen to provide a procedure for another. If the agreement between employee and employer is up front, I do not have an issue with it.

State run hospitals could require a new contract between employees that states that employees will perform all the procedures in the playbook. That way we know upfront who is willing to perform a late term abortion on the 14 year old girl who lacks parental consent. If an employee is into that type of thing, they can sign on the dotted line. If not, they can find a saint-sponsored facility of their choosing. From a patient's perspective, it'd be nice know which procedures hospitals provide.

It's not that I am against abortion. It's just that I don't think one person's moral flexibility should be imposed on another. With all the disincentives that appear on the horizon for HC: legal liability, reduced earnings, increased education costs, etc. Moral standing is not something I want to add to the list that discourages otherwise competent HC professionals.