Provider Conscience Regulation - Comments
Via Electronic Submission
September 25, 2008
Office of Public Health and Science
RE: Provider Conscience Regulation: Notice of Proposed Rulemaking 73 Fed. Reg. 50,274 (Aug. 26, 2008)
To the Office of Health and Public Service:
The Association of American Physicians and Surgeons (AAPS), a national organization of physicians in all specialties founded in 1943 to promote private medicine and the sanctity of the patient-physician relationship, supports the freedom-of-conscience rules proposed by Secretary Leavitt.
The United States of America was founded by people who suffered great hardships in order to live in accordance with their conscience. Freedom to practice one’s religion is one of the most sacred principles in our country. It is outrageous that Americans should be forced to fund, through their tax dollars, institutions that deny this fundamental right.
Federal rules and regulations already prohibit many forms of discrimination, as on the basis of race or sex, under penalty of losing taxpayer funding. Exercise of one’s freedom of conscience is at least as deserving of this protection as any other characteristic.
Medicine is based on trust. Patients need to be able to trust that physicians are able to act in accordance with their own best judgment about what is in the patient’s best interest. Medical professionals should not fear the loss of their ability to practice their profession if they decline to participate in procedures or treatment that they believe to be harmful or unethical, and hence not in the best interest of their patients. Nor should they be forced to refer patients to other practitioners who are, in the view of the referring professional, acting in a harmful or unethical manner.
Many Americans believe that government should not interfere with their ability to obtain procedures such as abortion, sterilization, or physician-assisted suicide.
However, their freedom to obtain such procedures does not impose an obligation upon another person to provide, facilitate, or pay for them.
Indeed, the law itself prohibits Americans from receiving many drugs or procedures simply because they have not met governmental requirements to prove safety or efficacy. Moreover, there is in fact no right to receive any particular medical service even if it is permitted by law. Services are unavailable for many reasons: lack of funds, lack of adequate personnel, or the belief by available personnel that a certain drug or procedure is not appropriate for a particular patient.
Americans do not lose their fundamental human rights simply because they have chosen a medical vocation. One of those rights is not to be compelled to perform acts they believe to be immoral or unethical.
Surely it is not in the interest of Americans to exclude from the medical professions individuals who are guided by their conscience and unwilling to act in a manner they believe to be unethical. The short-term objective of making certain desired procedures more readily available cannot justify the abrogation of physicians’ rights, and is not worth the loss of principled physicians and other medical professionals.
Taxpayer funds should not be used to fund institutions that engage in discrimination against persons of conscience.
Jane M. Orient, M.D.