The head of the dept of HHS is quick to point out that there ARE ALREADY at least 3 federal laws passed by our congress that protect the right of conscience for physicians. This proposed HHS rule is publicly linking the denial of federal funds to groups seeking to limit a physician’s right of conscience, based on the currently existing laws. If I understand what he wrote correctly, the head of HHS is publishing notice that federal funding already can be removed from entities that pass Board Certification rules (or state licensing rules) that attempt to force a doctor to perform procedures that violate his or her conscience.

The dept of HHS contends that an individual specialty, or group of doctors who happen to be “in power” does not have the right to force physicians l to violate their conscience as a condition of being licnesed or board certified. HHS based that opinion on already existing federal laws.

Particularly of concern are medical students and residents who are NOT in a position of power. They can be denied the right to practice in the specialty they have chosen, after numerous years of residency if for example, ACOG were to change the existing requirements to insist that they perform abortions. (ACOG does not after all, require its members to continue to deliver babies throughout their careers).

One of the duties of the federal government is to protect its citizens. So far at least, we as physicians are still considered citizens. If the leaders of ACOG were to succeed in their attempt to “force” physicians in training to perform abortions, that would just be the first step to forcing other things.

As Dr. Shane Macaulay (the first posting above) states, the next thing might be to require physicians to kill their patients (euthanasia). If we allow the rights of some physicians’ consciences to be violated, where does it stop?

This HHS regulation is not “the Bush Administration” “perpetrating something” on America. I think it is a notification to ACOG and other groups which seek to misuse their power to make THEIR view of right and wrong the “law” that they will be violating three or more already existing laws. That violation of federal law will rightly cost them and their institutions or corporations all their federal funding. (Why should we as taxpayers reward someone who breaks the law with federal money?)

Our existing laws already protect us as physicians, so far. But just as we need to fight “sham peer review” we need to fight for our right to follow our conscience, and for the rights of other physicians (who may be more conservative than we are) to not have to violate their consciences, as well.

In a rational society, an individual seeking a medical procedure would contract with a medical provider acting alone or as part of a company (medical facility) with which that provider has a contract, for a procedure that the individual has decided is in hir best interest as provided by this particular provider. The medical provider would be at liberty to offer or not offer any particular procedure/treatment depending on hir own evaluation of its potential benefit and other attributes, including hir own view of its morality - if sh/e has been wise in having such a contract with the medical facility that provides hir with working space and equipment. A medical facility would also be at liberty to contract or not with a medical provider who chooses to not provide certain procedures/treatments. In all cases in a minimally acceptable society, government would play no role in these decisions - it would only adjudicate in situations of breach of contract (unless the parties had included a private arbitration clause in the contract). In such a society, any taxes that were collected would not be used to interfere in voluntary actions between parties and therefore anyone whose moral views held a certain procedure/treatment to be unacceptable would not be required to provide it, accept it or financially support it.

Discrimination - originally meaning the judicious use of one’s reasoning faculties to decide to not interact with another person or to not perform particular actions - has become a pejorative applied to enormously many acts of less than full acceptance of persons and their actions. But one should ask if it is in hir own best interest (defined as what maximizes hir own lifetime happiness) to be accepting of everyone and anything. While such discrimination or non-acceptance most certainly does not imply any right to initiate interference with the mutually voluntary interactions of any individuals, it also most definitely does mean that one should not be required to financially support (via money from taxes) those persons or actions of which one disapproves.

With governments being granted, by the voting residents in democratic nations, the liberty to enforce the views/wants of the majority of voters (or at least the views/wants of those elected by those voters), a cascading series of problems is inevitable. The contents of the AAPS 9/4/2008 article, “Is freedom of conscience at risk?” demonstrates just some of them. The only way to begin to unravel this tangle of apparent conflicts, is for large numbers of people to recognize and accept the role of the individual as the responsible entity for thought and action followed by the non-interference by others in the mutually voluntary interactions of the involved parties. Then and only then can the government-created problems - in this case of requiring individuals to perform and/or financially support actions with which they do not agree - for any reason, begin to be eliminated.

Hence I strongly *oppose* the proposed Bush administration measure which would carve out a special exemption to protect religious health care workers who prefer not to provide abortion services or information out of “conscience”.

This issue should be purely a matter of private contract between health care workers and employers, without federal intrusion. In a free society, a pharmacist has the right not to fill certain prescriptions that violate his religious beliefs. And his employer has the right to fire him.

If the pharmacist’s conscience does not permit him to abide by the terms of a voluntary employment contract, he should find a different employer, not demand a right to a position where he cannot meet the job requirements.