A controversial rule that allows healthcare providers to not be required to provide healthcare services that conflict with their religious beliefssuch as abortionis about to be overturned. The move is bound to create divisions between secular and religious healthcare organizations.
Obama plan to rescind rule draws Catholic criticism
President Barack Obama took steps this month to rescind a final rule related to the conscience rights of healthcare providers that the Bush administration had put into effect just months ago. A notice to roll back the rulemaking was published by HHS in the Federal Register on March 10, giving providers until April 9 to comment on the change of plans.
Catholic hospitals have already made it clear theyre not going to support an elimination of the rule, which had essentially been enacted to add some regulatory teeth to a number of existing statutes designed to safeguard provider conscience rights. Obama also recently repealed a ban on funding of most types of embryonic stem-cell research, a move that may put Catholic hospitals at a competitive disadvantage (March 16, p. 6).
The fight is more than symbolic, according to proponents of the Bush rule. The Bush regulations scope is no broader than that of the existing statutes, but it faithfully implements and enforces these statutes in several ways that make their protection of conscience more effective, according to Richard Doerflinger, associate director of the U.S. Conference of Catholic Bishops Secretariat of Pro-Life Activities.
As an example, the rulemaking provides an enforcement mechanism, instructing those who think their rights are being violated to appeal to the HHS Office of Civil Rights. A statute, by comparison, may have little effect if no one knows where to go to get help, the bishops group stated.
The debate seems to be gaining public exposure, with Chicagos Cardinal Francis George, president of the bishops group, recently urging Catholics to tell the Obama administration to retain the conscience regulations.
Respect for personal conscience and freedom of religion as such ensures our basic freedom from government oppression. No government should come between an individual person and Godthats what America is supposed to be about, George said.
The Conference of Catholic Bishops tried to further push its position through the use of video statements from George, a physician, a nurse and medical students available on its Web site.
Within the healthcare ranks, church-affiliated groups such as the Catholic Health Association are pushing for retention of the regulations. The CHA has long supported and worked for the enactment of conscience clause protections, such as the Public Health Service Act, Sister Carol Keehan, president and chief executive officer of the CHA, said in a written statement. The statute had been enacted in 1996 to prohibit the federal government and state or local governments receiving federal financial assistance from discriminating against healthcare providers who refused to perform abortions or related activities.
Regardless of any amendment or rescission, Keehan believes that the federal conscience protection laws will continue in force and remain valid. The group had spelled out its reasoning in comments to the Bush administration last year, claiming that Catholics and others with deep respect for the sanctity of life must not be forced to perform proceduressuch as the taking of the life of the unbornthat are contrary to their deeply held moral beliefs and principles.
Joyce Ross, spokeswoman for not-for-profit Catholic Health Initiatives, Denver, said that CHI would be working with the CHA to provide a response to the proposed rule change by April 9. Conscience-clause provisions have protected the right of healthcare providers to decline to provide services that are contrary to religious beliefs and moral convictions for many years, and we expect that will continue, she said.
But other provider groups, such as the American Hospital Association and various physician groups, such as the American Medical Association, agree with Obama that the Bush administrations rulemaking should be withdrawn.
The AHA has argued the new rulemaking would create a certification process to enforce a series of federal provider conscience protections. Failure to comply with this process would result in a severe penalty, the loss of federal funds, the group pointed out in comments to the Bush administration last fall.
In addition, the rulemaking would also likely conflict with state and federal laws that require hospitals to provide certain services, such as the issuance of emergency contraceptives to rape victims in emergency departments, the AHA stated.
The American College of Obstetricians and Gynecologists declined comment. However, previous opinions issued by the organization have specified that physicians and other healthcare providers have the duty of giving their patients prior notice of their personal, moral commitments and should refer patients to other providers if a moral conflict arises.
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