That abortion law people have been raging about...

[dangermousie]

Warning: this is likely to be a very unpopular opinion. But seriously, I kept thinking it and finally had to come out with it.

(This is about the recently passed bill which would prohibit retaliation against medical personnel who refuse to provide abortion).

No, the sky is not falling.

Seriously.

This is just codifying something which is de facto law already.

Before I get to this, one separate point though:

You know, most medical professionals do not sign on to do abortions, or even on the chance that they might have to. You know why? Because the only people who perform them are either professionals working at abortion clinics or (in some rare event, such as an emergency), an E.R. doctor. This does not affect the vast majority of doctors, nurses, technicians or anyone else. Chances of a podiatrist or a midwife or a physical therapist conducting or assisting in an abortion? Next to none.

So yes, ER doctors (and assistants) and abortion clinics people.

Guess what, you can't force someone to perform a service. There is a provision against involuntary servitude based on 13th amendment which has been invoked in a whole slew of situations, from school children having to clean schools to chain gangs. What it means? You cannot force a doctor, a nurse, or that person who boils the metal instruments to perform a function they do not want to do.

"Yes, but before you could fire them and that would scare them into doing abortions!"

Not really. Most abortions are performed in clinics like Planned Parenthood, right? Well, I don't think anyone who is not a-Ok with abortions would apply to work there, but let's say somebody did and got hired. PP might not be able to fire them because they refused to do abortions on moral grounds, but they can certainly fire them for either falsifying an important fact on their application (I would imagine any sane org that does a controversial procedure would ask about the applicant's willingness to engage in it) or because they cannot perform the duties of their position which consist of abortions. An example is the law that prohibits gender discrimination in employment, but there are a series of cases that say that e.g. a strip club or even Hooters can hire only busty ladies because being a busty lady is a qualification of the job. Just as you are not supposed to discriminate against the handicapped but if the person's being handycapped interferes with the duties of the job, then you can certainly only insist on hiring able-bodied workers.

E.R. is obviously a more mixed case because the personnel's job descriptions include more than performing/assisting abortions (though I still think it's a good argument in that case as well. You are not penalizing them for their beliefs, you are transferring them for insufficient performance). But leaving aside that practically speaking you can find more than one doctor/nurse/cloth-holder in the hospital, I would imagine vast majority of abortions performed in ERs are emergency procedures to save life of the mother or what not. Even a lot of people who are anti-abortion are OK with that, but even leaving that aside, somebody who is willing to let a person die because aborting is against their moral beliefs would not be deterred by a prospect of firing, realistically speaking. Not to mention that from what I know of ER docs, religious right is hardly a thriving group among them.

So basically, storm in a teacup. Good way for conservative politicians to score points with their consituents without doing anything meaningful.

(Disclaimer: Yes, I am pro-choice. Yes, I find forcing people into doing actions that go against their moral beliefs distasteful).

Comments

[svilleficrecs.livejournal.com]

I don't know about everyone else, but for me, the disturbing part of this isn't that people can refuse to provide services and not get fired, it's that oral contraceptives have been reclassified as abortion under this rule. And codifying that into law *is* potentially a part of a slippery slope that the anti-choicers very much are trying to grease. One that denies me not just access to an abortion, but access to birth control.

[tatterpunk.livejournal.com]

the disturbing part of this isn't that people can refuse to provide services and not get fired, it's that oral contraceptives have been reclassified as abortion under this rule.

Exactement.

[svilleficrecs.livejournal.com]

Plus, no one's *forcing* them to perform abortions. No one went into their church and dragged them to the operating and shoved a vacuum into their hands. There are about a million other jobs out there that have nothing to do with abortions or contraception, but if they choose to take that job, I don't see why they shouldn't be expected to perform the requirements of that job. Or get fired if they refuse. If you have moral or religious issues with certain parts of a job, why take that job? Not to mention there are no provisions for providing a patient *denied* care. If someone takes the time off of their job to get a *legal* procedure done and at the last minute some anesthesiologist decides to scrub out (or whatever) it's my understanding that the service provider is protected, but is the patient SOL? Are they given a refund? Transport to a facility that can take care of them? Compensation for their wasted time? Guaranteed rescheduling somewhere else? What if they're near the cutoff date? I've seen no provisions to safeguard the patient's rights - the patient who is in the time sensitive position, and who is a paying customer - only the objector's.

I'm sorry, but if you don't want to provide abortions or contraception, don't take a job somewhere that provides them. I've never been denied contraception, but I have, once, gotten my prescription filled by a pharmacist who gave me a dirty look and told me, "I'd never let my wife take those." I wasn't ballsy enough then to tell him, "Go fuck yourself and I'm glad I'm not her," but I was mildly humiliated and felt a little dirty the rest of the day. I've got nothing against people chosing not to use birth control, but it's my belief that if you've got a moral/religious objection to doing a basic requirement of a job, you should find another job, not expect the job to bend to your religious/moral beliefs.

[tatterpunk.livejournal.com]

Imagine me nodding vigorously and punching my fist in the air for your entire comment, but I also just want to add to this:

I wasn't ballsy enough then to tell him, "Go fuck yourself and I'm glad I'm not her," but I was mildly humiliated and felt a little dirty the rest of the day.

This, this right here is the crux of the issue in miniature.

NO ONE should receive harassment because of their medical needs. Refusing treatment is a form of harassment. Refusing a referral is a form of harassment. Taking the opportunity to make a verbal judgment blatant, no-other-word-for-it harassment. This is unconscionable.

The fact is, a ruling on "moral beliefs" gives medical providers opportunity to pass comment on their patients sexual practices and basic lifestyle, silently or not. That's such a violation of privacy, I can't even. No human being should have to feel like their life must be weighed in judgment to gain access to a legal right.

[animeshon.livejournal.com]

oral contraceptives have been reclassified as abortion under this rule

This really is a worry, contraceptive has always been shaky ground, especially when it comes to religion, to have it reclassified as abortion, really is opening up a huge can of worms in terms of preventing unwanted pregnancies

[neadods.livejournal.com]

It's two things that bother me - first, as you say, it's the reclassification of birth control as abortion. The second is the reclassification objection to any action or service that may contain any taint of the objected goal, be it abortion or birth control or whatever.

Over on my journal is the true story of a pharmacist, Neil T. Noeson, who refused to not only deal with birth control, but also refused to tell the other pharmacists in the office that there was someone at the desk who wanted it, and also refused to answer the telephone lest he be asked about it. This goes beyond drawing the line of "what I cannot in good conscience do" and throwing an undue burden on everyone else around them. If you cannot in good conscience even answer the telephone at your place of employment, how can you legitimately argue that you should not be in a different branch of health care, or working for one of the already-established pro-life pharmacies?

[angelicus.livejournal.com]

Baby steps. Inch by inch, useless law after useless law, and eventually they will get their way and abortions will once again be illegal. Instead of a big dramatic ruling or case, they will sneak by all these mini laws where everyone says, "See? That's not so bad. It's not making abortion illegal or anything." But eventually there will be more and more of these, until bye bye Roe-v-Wade.

[meganbmoore.livejournal.com]

Actually, no one (that I know of) objects to the abortion part specifically. It's the part where the rule states any preventive or sterilization procedures that people object to. This includes the medicine they give rape victims to prevent pregnancy, any birth control (even medications not primarily intended for that person) and any emergency operations. If it have a chance to end or prevent a pregnancy then, no matter why it's needed or wanted, it can be refused. It also says that it can be done at any point in time. While an abortion can be acquired elsewhere (such as an abortion clinic) many of these can't, and the services mostly won't be needed in the ER, but in that specific field, which people do enter knowing that may be a requirement. In addition, a lot of insurance will only cover one or two providers, limiting your options.

On a more minor point, in the past, medical professionals have been required to refer patients elsewhere. That's no longer the case.

It's being discussed primarily in the context of abortion, likely because it's such a hot button for most people, but that's only one factor. And, frankly, a minor one.

[svilleficrecs.livejournal.com]

Not to mention that if you're well off/privileged, you've got the option to shop around and go from hospital to clinic to hospital until you find somewhere that can provide you with the services you want. If you're unlucky enough to be poor, driving another two hundred miles might not be an option. Laws like these that work to "inconvenience" the person seeking the procedure might be an inconvenience to middle and upper class people, but to the financially disadvantaged, they can have the effect of being an insurmountable obstacle.

But then that's always been the case, hasn't it. If you've got the money and the time, you can always find a quiet doctor to take care of your daughter's "little problem". If you don't, you're SOL, or (if you're in a desperate enough situation) you're going to someone unlicensed. And hopefully, I don't have to go into the horrific details of what the alternative to "safe and legal" was like.

[meganbmoore.livejournal.com]

Yup. There are some employers here whose insurance only covers one local hospital, and clinics associated with it. My insurance doesn't have that limitation, thankfully, but then, nothing in the law actually applies to me personally. Doesn't mean I'm not aware that it could, or to someone I know. Such as my sister-in-law, who had a difficult pregnancy, and wants more kids, but not yet.

Unfortunately, it seems you probably do have to go into details in some places. And while abortion isn't the main point of this law, it really is one step closer to limiting access. And regardless of any personal feelings I have on the subject of abortion (which I won't get into) I don't think anyone should forget why it became legal in the first place.

[tatterpunk.livejournal.com]

Other people have made the truly pertinent points, but I will add this: if medical doctors are given the right to refuse a service they object to on moral grounds (or, refer them to someone who will), then it is possible to use such legislature to start refusing a service because one has moral objections to the patient; i.e., I do not usually object to heart transplants but I have an moral objection to performing a heart transplant on a known drug lord/ex-con/prostitute when there is a soccer mom of three wanting one down the hall.

I'm not saying it would immediately start to happen, but it might open the door.

[meganbmoore.livejournal.com]

Oh, I don't think there's any "might" to it. "Precedence" is a cherished word in the justice system. And you don't even need the soccer mom part.

[tatterpunk.livejournal.com]

Exactly. This isn't just a steep slope -- this is one slicked up with oil.

[tatterpunk.livejournal.com]

Plus, other professions that could be influenced by "moral objections": teachers who personally believe in intelligent design refusing to teach the school-mandated curriculum of evolutionary theory, major booksellers like chains or Amazon refusing to make certain books available, a nurse at a uni clinic refusing to leave out the condom bowl during her watch... If you have been trained and are paid to provide a service, there is no constitutional right to deny facets of that service.

Doctors, especially those who have studied less popular fields (like women's health), receive specific federal and private grants to fund their schooling and/or lifestyle while they train. To take advantage of resources specifically laid aside to encourage med students to provide certain services, and then refuse to perform those services for the general public is hypocritical in the extreme.

[scottishlass.livejournal.com]

Honestly, for me it is hard to understand. The generation of our mothers have fought hard to have pro-choice, that *their bellies belong only to them* and not to state or religion.
A couple of years ago the Christian Democratic Union (the government party atm) tried to change the abortion laws over here and was met with an outcry of the public. From arguments starting from the segregation of religion and state to demands that those so-called pro-life organisations and churches will have to take in the unwanted children once they were born - all was present. You know what did the trick? The demand to regulate the caring of these unwanted children by the state and churches. Where money is concerned at least the German pro-lifers easily shut up.

Personally, I would never live in a country that denies me both contraception and abortion. Not having kids whether it is a choice or a medical decision (as it is with me - I have a 50 percent chance of having bodily disabled children due to a genetic defect) should be a decision by the women not by some old men whose sign of the times have blissfully passed them by.

[animeshon.livejournal.com]

I completely agree with you, people have the right to make a decision which actions they do not want to do. If performing an abortion is against the morals of someone, then they should not have to perform one. I fully believe in people's right to choose one way or the other. The problem lies when hospitals which believe in preventing abortions, do not allow patients the option of having one performed. I remember reading about a Catholic hospital that for one reason or another wouldn't allow an abortion to be performed (I can't remember why it was such a big deal, but it was), in these cases, they should make arrangements for patients to be transfered somewhere that will allow the procedure to be performed.

religion + ER doctors = confusion, I've never met one who had any great religious views (and trust me I've met plenty!)

[alexandral.livejournal.com]

Like scottishlass I find it is strange for me to see that there might be even a question about forbidding abortion (and contraception) on a country level. It seems that USA government is sliding from the democracy it is trying to preach more and more.

But! I don't agree that religion and doctor's profession are two incompatible things. In our church there are doctors and midwifes, so extrapolating - I guess in other churches there must some too. I guess I find that "making" doctors perform an abortion against their beliefs is also against their human rights. But as you - I don't remember any of the doctors I know ever having to take a part in abortion.

Also, I don't think that all anti-abortionists are "religious right". I am against abortion for myself (but for myself only) , but not because of my Christian beliefs ( I don't know where on the scale of right/left these beliefs go) , but because of the things I went through when I was young. I was anti-abortion (again, for myself) long before I became a Christian.

I think this law is a bit of a big red herring. The government is probably trying to pacify anti-abortionists by giving them this law which in reality is useless and will never be applied , but also gives a way out for doctors who don't want to do abortions.

I can think about one application of the law which is legit - for example, take interns and medical students. I haven't studied the medicine myself but I imagine like any studies you have to do what you are told to do and you have to do different things, something you don't chose as your qualification. Under this law Students/Interns that don't want to take a part in abortions have an opportunity to say no.

[dangermousie.livejournal.com]

It seems that USA government is sliding from the democracy it is trying to preach more and more.


Not really. If e.g. a majority of the people in US believed abortion was wrong, it would be democratic to ban it if you are going by sheer 'majority' principle (there is a rule about protecting minority rights which I think is a good thing, but regardless, you do not need that rule to be a democracy).

Actually, even if Roe v. Wade got repealed, all it would mean is that the right to decide whether abortions were legal or not would devolve back on the states, it does not mean a ban. Since there would be no federal consitutional right to abortion then, each state would decide what to do. Some conservative states like Alabama and North Dakota I am sure would ban it, and some liberal states like Massachusetts and California would allow it. It would only make a difference for a person living in a conservative state. And even then, they can travel to a different state to have it done, so practically speaking it would affect only the poor who cannot afford to (but then I'd imagine rights activists could organize trips). If a state tried to make illegal to go to another state to get abortion, it would open a host of other constitutional issues...interfering with constitutional right to travel, conflict of laws etc etc. Practically speaking, it would not be a ban that would stand up in court.

Basically, I just do not see the brouhaha but I admit abortion is just not an issue that is an end-all-and-be-all for me. Sure, it's important, but I care about other issues of more immediate concern to me more.

Also re: religious right. In the US, this is who are the people who are rabidly and politically anti-abortion.

[ysrith.livejournal.com]

I find the above comments interesting.

First off let me state -I am pro-choice and pro-information. Then let me state I am a doctor, and I have been in the position where I have had to consider my own personal beliefs on abortion and how I do my job.

As a member of the medical profession, who now works in a country where abortion is legal, and who trained in Ireland during the abortion referendums I have had to sit down and think long and hard about this issue, and what it means to me both ethically and professionally.

I personally could not have an abortion nor could I ever perform one. When I came to the UK, I was considering Paediatric Pathology as a career, but found that in the UK where abortion is common I would end up doing post-mortems on post-abortion foetuses. I was surprised how upsetting I found this, and decided that I could not do it. I feel that the UK abortion on demand laws are basically used as a form of contraception , therefore I personally cannot be involved in that service.

HOWEVER these are my personal beliefs. I am pro-information and pro-choice. I believe that every woman should have the information and the option, and once given the information from both sides, that it is her choice.

Just as it is my choice not to be involved in the practise of abortion.
The law in the UK is such that it allows a doctor or nurse to opt-out.
The ability of a doctor to be able to choose this is extremely important. You cannot force someone to do something that is against their ethical beliefs. That is where a law like this is essential. To say that you should not go into a job because you may have religious beliefs that would affect it is not the answer. I did not think I would have the reaction I did when I started work in the UK. By extension of that argument no devout Catholic or Muslim would ever be able to practise medicine.

However, I strongly believe every doctor must sit down and make their own ethical decision in relation to this. However, I also believe that every doctor must then ensure that they are honest with the patient, tell them why they cannot and then offer them the choice to go elsewhere and at least give them access to other people who will be able to perform the service.

I can understand the reaction that this is affecting women's rights in the US and I agree. There is a danger that it will be abused by those who cannot separate their own personal beliefs from their medical practise.
And to me, this is unethical. Allowing your personal beliefs to affect someone else's care is wrong. If you cannot provide that aspect of care, then you must at least, send the patient to someone who can.

In an ideal world, this is what a law like this would support. Given the radicalised pro-life movement in the US, it will be abused and used as a means of enforcing religious convictions.

It saddens me as a medic that fellow professionals use a law like this in such an unethical manner

As for the oral contraception aspect. I had seen the comments on how it is being abused in neighbourhoods when the one pharmacist is available and therefore forcing their own beliefs on others. Again, ethically this is so wrong. Surely there should be some rider that makes so single practice policy's illegal

It is all about choice.

[alexandral.livejournal.com]

Not really. If e.g. a majority of the people in US believed abortion was wrong, it would be democratic to ban it if you are going by sheer 'majority' principle (there is a rule about protecting minority rights which I think is a good thing, but regardless, you do not need that rule to be a democracy).

But this is what I mean - it seems that majority is pro-choice (it is difficult for me to imagine a present-day developed country where this isn't true) so if government issues a law that goes against the wishes of the majority this is not that democratic? There wasn't a free-vote on this question, right? I am very vague on all these political things but it seems that women's right to choose is one of the basic human rights.

religious right. In the US, this is who are the people who are rabidly and politically anti-abortion

I see! In UK I guess, we don't have so far any of the groups of this sort, and if we have any they aren't too loud. However, pro- and anti- still exists and different people have different views.

I can see the importance of the question but at the same time I can see why a large percent of the population could be not too bothered. And surely, this is NOT the most important issue, it just seems to have risen to such importance. Here in UK I haven't heard the word "abortion" even mentioned for the last 10 years I am living here (I am not even kidding!).

[dangermousie.livejournal.com]

it seems that majority is pro-choice

But this is where federalism comes in, i.e. the fact that in the US, the government is not purely nation-level, but each state retains autonomy and differences. Majority of people in New Hampshire might be pro choice, but a majority of people in Mississipi probably are not. It really depends from state to state. This is where the question of whether abortion is a state issue or a federal issue comes in. If it is a state issue, then concievably a state where majority of people are anti-abortion, has a right to have an antiabortion law on the books.

In any event, in the US it's a pretty evenly split issue. Wiki sites 2007 polls: "Two polls were released in May of 2007 asking Americans "With respect to the abortion issue, would you consider yourself to be pro-choice or pro-life?" May 4th through 6th, a CNN poll found 45% said pro-choice and 50% said pro-life.[18] Within the following week, a Gallup poll found 49% responding pro-choice and 45% pro-life."

So basically, it's hardly trampling upon the wishes of majority of its citizens to have stricter controls (politicians being politicians, if 80% of the populace was pro choice, you'd bet they'd be proudly sponsoring Planned Parenthood).

As to developed countries. Abortion is illegal in Ireland except for danger to the mother.

[alexandral.livejournal.com]

"Two polls were released in May of 2007 asking Americans "With respect to the abortion issue, would you consider yourself to be pro-choice or pro-life?" May 4th through 6th, a CNN poll found 45% said pro-choice and 50% said pro-life.[18] Within the following week, a Gallup poll found 49% responding pro-choice and 45% pro-life."

Thank you very much for this info - I understand the issue more clearly now, guess this is where the problem comes from. Half/Half is a very tricky number and I guess the polar ends of each half are pretty loud. This is also not helped by the recent advances in medicine .

Oh, my apologies - I just noticed that I posted my previous comment in the wrong place!