On the day before President Bush leaves office, a rule will go into effect that forces health care facilities that receive federal funding to put into writing a vow that they will not punish employees who refuse patient care they find morally objectionable. Shortly thereafter, the new president will rescind the rule or Congress will override it.
Two things are certain: This rule will not stand, and it will make a mess. It would have been better if administration officials had just accepted defeat, but they decided to knock over the furniture on the way out.
U.S. Health and Human Services Secretary Mike Leavitt announced last week that his agency had finalized the rule, which was a long time in the making and had not received popular support. Though the rule talks about a worker’s conscience in general, this is clearly about abortion and other reproductive issues.
The United States already has laws that protect health care workers from being involved in abortions. The Civil Rights Act of 1964 protects workers from discrimination based on religion. HHS acknowledges this, but says the rule is needed to raise awareness. There are easier ways to do that than forcing more than a half-million clinics, hospitals and health care centers to certify compliance or risk losing funds.
Leavitt’s press release signals that he’s aware of the complications that could arise, but he doesn’t make any tangible effort to address them. He urges health care providers and patients to have upfront, frank conversations about delicate matters, but the ruling doesn’t require that. In fact, it doesn’t even say objecting caregivers have to deliver complete information or suggest options.
They can just refuse and walk away.
The rule would hit low-income patients particularly hard, because they rely more on federally subsidized facilities. Women who are raped and could avoid pregnancies with emergency contraceptives can be turned down on moral grounds. They don’t even have to be informed that such pills exist. Once they arrive in the emergency room, their fate could hinge on who is working that night.
Such luck-of-the-draw care cannot be allowed to stand. Health care providers understand this. The American Medical Association and the American Hospital Association oppose the ruling. So does the National Association of Chain Drug Stores, because their pharmacies would be affected.
States such as Washington have been battling over these “conscience laws” for years. This rule would wipe out those efforts. That is, if it stands. The good news is that it won’t. U.S. Sens. Patty Murray, D-Wash., and Hillary Clinton, D-N.Y, had already introduced a resolution in November, just in case HHS made such a ruling.
This was a petty move by the administration, and it deserves to be reversed as soon as possible. Health care providers can work this out with their employees without affecting patients or violating civil rights law.