For all those pharmacists and nurses and doctors out there who think that they ought to be able to have a conscience clause regarding abortion? To the point of not even referring patients to willing medical practitioners?
What do you think about the idea that a pacifist should be able to join volunteer as a sniper (edited for clarity) in the military and expect to draw a pay check and advance in rank while exercising a conscience clause with respect to weapons that kill people?
More trivially, what do you think about the idea that a car salesyard should have no recourse to fire a salesperson who exercises a conscience clause with respect to lying about how the proprietary finance plan is by far the best option to pay for this here car?
I’m guessing that, at least if you are honest, you see those two examples would never fly with exemptions made for conscience clauses. What a grandiose sense of entitlement, to claim recompense for not doing what the nature of the job patently requires, and which nobody ever concealed about the nature of the job, either.
So why do you think that it is reasonable to demand that health professions make provision for your particular conscientious objections?
If you don’t want to be associated with abortions, then (a) don’t enter fields of employment where abortion is part of the range of practice, and (b) don’t whine about how that field of employment is oppressing you by requiring certain things that you are unwilling to do.
QED.
Categories: culture wars, ethics & philosophy, health
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And, happily, abortion involves neither killing people nor lying. So it’s a far sight less difficult a decision to make – or it should be – than either of the above. I went into medicine to help people, not to kill people or lie, and abortion (counselling and referral; I’m non-procedural) fits in quite neatly with that.
Except of course the people who want to exercise a conscience clause do believe that abortion involves killing people, so it’s disingenuous to say “happily, abortion involves neither killing people nor lying.” You and I don’t see it as killing people, but other folks do, and I understand why they might be unwilling to be party to it. My (physician) dad’s partner was a Roman Catholic; he would prescribe birth control pills, but IUDs fell to my dad. My dad would refer for abortion, but he chose not to perform them himself. To address Tigtog’s first analogy, my cousin was a conscientious objector in WWII, but he served in uniform. He was a medic, on the front lines in Europe. He did not carry a weapon. The US Army paid him, though, in spite of his refusal to kill other soldiers. They just put him to work saving lives instead of taking them.
I’m sure that there are a lot of pharmacists out there who entered the field before there was an abortion pill or Plan B. Should they now close their shops or limit their sales to OTC sales of vitamins and cold remedies? The real issue with a conscience clause for pharmacists arises when said pharmacist is the only one in a 100-mile radius. A teen who needs Plan B and doesn’t have a car is SOL. I agree fully that that is a serious problem, and I don’t have a good solution. I wish I did. I’m not sure that forcing people to commit murder (in their own eyes and according to their own codes) is the answer.
c) suck it up.
People with clean consciencences would never be able to work in this economic system without sucking it up.
@ Vicki:
I mentioned rank in that analogy for a reason – I bet your cousin never whined about not being promoted because he exercised his conscience, did he? Also, he would have been conscripted, no?
Nobody’s conscripting anybody into becoming pharmacists, nurses or doctors.
What if Christian Scientists started a movement in this country to become pharmacists so they could refuse to dispense any medication at all–just told people to pray and let God take care of it? That’s the kind of faith that would scare even the Christianists.
A teen who needs Plan B and doesn’t have a car is SOL. I agree fully that that is a serious problem, and I don’t have a good solution. I wish I did.
In Australia (and in many parts of the US) that is the case for MANY people.
I’m not sure that forcing people to commit murder (in their own eyes and according to their own codes) is the answer.
In this case, it’s reinforcing and giving credence to their view.
Doesn’t it boil down to practitioners holding their ideological beliefs above the rights of the client, because “god” said it was ok?
Since when does a fictitious supernatural character get to have a say about public policy?
As a welfare worker, I’d love to see more indications of clean conscience from services like real estate, financial lenders/debt collectors, and utility providers; services that actually do real harm in the community (including to children), as opposed to removing cell clusters from women’s uteri.
I work in an isolated rural pharmacy. We have never, and will never, refuse reproductive services on any grounds other than patient safety (in which case our policy is referral, though we haven’t had to do this yet), and our tiny hospital has a similar policy. The medical staff who sit in judgement make me extraordinarily angry. There are medical fields crying out for staff – in particular, aged care – where these religious decisions will never be relevant and the anti-contraceptive, anti-abortion people can use their skills to help people, rather than harm.
My sceptical view is that it’s more about inflicting their views on others than actually helping people. I have no issues with Drs who refuse to perform abortions, or even pharmacists who won’t fill scripts for birth control pills as long as they give information about who will – and there is someone close by who will do it. Even if they just take a pamphlet out of their bottom draw and give it to the person as they leave. Yes you have the right to object, but no you don’t have the right to inflict your views on others when they have no other choice.
Can you imagine the uproar if a Jehovah’s Witness doctor refused to give a patient a blood transfusion?
The other point that I probably should have made in the post is that the healthcare professions are registered by the State for a reason – to guarantee a certain quality of training and service provision so that the public is protected from charlatans and incompetents.
In return, the State protects these professions from competition from those who have not undergone the appropriate training and/or do not provide the services required of that profession by the State: people can be fined and even imprisoned for impersonating a registered health professional.
This protection of these professions comes with a quid pro quo: so long as a health procedure or product is legal in the State, a health professional should not be allowed to prevent anyone from accessing it. Certainly no-one should be forced to personally commit any act they find repugnant for any reason, but neither should they be allowed to withhold any relevant information from anybody regarding any legal procedure/product, or withhold a referral to another health professional who does not share their conscientious objection.
Also to what lilacsigil said: yes, there are fields of healthcare, especially for nurses and doctors, where the question of abortion will never arise. Objectors should choose one of those areas.
See the Protection of Conscience Project for background materials and other information on this subject.
@tigtog
I can’t speak for how it works in other militaries, but a medic certainly would not be barred from advancement in the US military even if s/he refused to carry a weapon and did not kill people. US Navy Hospital Corpsmen who spend their entire careers serving on shore at hospitals and clinics and thus are not directly involved in the Navy’s combat mission by serving on a warship still advance, the same as the Hospital Corpsmen afloat do. The same holds true for medics in the Army and in the Air Force (the US Marine Corps gets its medics from the Navy).
As long as said pacifist does the job well and takes care of the patients, then yes, I do think they should be allowed to join the military and exercise a conscience clause to refuse to carry a weapon or kill “the enemy.”
On the other hand, I don’t feel that as a medic, that pacifist should be able to decide to withhold a treatment s/he finds morally objectionable, as the pharmacists over here who have refused not only to fill a scrip but to even give it back to the patient have done.
I’m not sure where my personal line is there. It’s a broad and fuzzy line at best.
But if advancement in the military were dependent on your kill count, I’d be a frickin admiral.
Do you have a link Sean?
Mindy, click on Sean’s name – he linked it there.
Right, thanks. Ahem. *slinks away to hide shame*
I disagree – we have far too many problems already with shortages of medical staff to be further limiting them.
I think there is enough flexibility in the system to allow for conscientious objectors.
I don’t have an issue allowing for them, as long as there are alternatives for the people who need those services to which those service providers object. If there are no alternatives, then you have to make the ethical choice which is to put the wellbeing of the patient first, regardless of your personal views.
A hypothetical:
A young hetero couple in a long term monogamous relationship who plan to have children at some stage but not yet, living in a small country town with one chemist, one service station, one local shop all owned by the same very Catholic owner. They don’t have access to the contraceptive pill because it goes against the owner’s beliefs, nor do they have access to condoms because the other stores that could stock them are owned by the same person. They would have to travel a fair distance to the ‘big city’ to access these contraceptive options, which is quite a journey. So the options they are left with is to either a) have children before they are ready, or b) practice abstinence, neither of which accord with their beliefs but do accord with the beliefs of the owner of the shops in town. Is this a reasonable thing to do to someone else because of your own religious beliefs?
The problem is that for religious objectors, there’s a different standard of ethics in play, and that makes the argument (at least from what I’ve seen here on the US end) really difficult. Because for many people, it would be a breach of their ethics to supply contraceptives. (And often they don’t believe in the supremacy of democratic government over any potential religious law…)
Which does not mean I think that’s right–too bad, so sad, get out of the potentially risky business if you intend to serve the general public, is my view. It’s just so hard to convince people of that when they’re wired into this entirely different system.
Ben – yes, I agree that the issue is seen as one of religion rather than democracy, and that’s why actual laws are needed to protect the patient. Doctors/pharmacists/nurses should either do their jobs or work in a different field – their options could be as simple as referring to another staff member where there is one, and be banned from working alone. Otherwise, there’s plenty of work for them in their actual fields without this issue arising. If the pharmacy where I work decided not dispense contraception, then people would have to drive 45-60km to access it, depending whether they went west or north, or up to 200km on Sundays and public holidays. A single pharmacist could have a horrific impact on public health, and we’re not even particularly isolated compared to Central Australia.
I think the military analogy needs refining: it would be more like going into the military, training in a combat role, getting into the field and under fire with your buddies, and then turning around and refusing to do the job you signed up for, while putting others in danger.
I don’t think many people opposed to conscience clauses object to healthcare practitioners training in medicine/pharmacy/nursing, and then ensuring that they’re in a subspecialty and workplace that won’t cause their conscience clause to adversely impact women. (See: the example above about going into geriatrics, for example.)
Vicki: I’m not so sure that “I went into it before we had emergency contraception!” works for me. The exact protocol used as standard of care until very recently, the Yuzpe method, has been around since the early 1970s, and there were some attempts at hormonal EC in the 1960s. They’ve had an awful whole lot of time to re-manoeuvre a career into a field that doesn’t involve turning folks in need away. And I really don’t see, even if someone does find themself somehow inadvertently in that position through wilful thoughtlessness, how they excuse to themselves things like publicly humiliating women who have asked them for help, or holding prescriptions hostage.
That is much more what I had in mind, yes.
Nothing on my Christian Scientist post? I thought it was a good analogy. I think it’s talking-point worthy, if I do say so myself. (Actually, it was my husband’s idea. It was so good I wanted to share it.) Unless we’re worried that all the talk would get Christian Scientists organized to do something like that.
Another thought along a different line of making women “aware” of the consequences of their abortions: what if doctors or pharmacists had to show people videos/pictures of the possible side effects of their medication before they were allowed to buy their drugs?
We get information sheets about the possible side effects, which for many people never eventuate. Why should people be scared away from taking medication that they need?
crystal shard – medical training involves a good deal of hands-on work, so genuine Christian Scientists who refused to give medication would never become qualified.
And medical staff *do* give information about possible side-effects, as well as the actual purpose of the medication. The purpose is to educate, not intimidate, but it’s true that some people do get so worried about side-effects (possible or actual) that they decide not to take the medication. Which is, of course, their choice, but consultation with the pharmacist usually helps them make an informed decision about risks and benefits rather than an uninformed decision.
“what if doctors or pharmacists had to show people videos/pictures of the possible side effects of their medication before they were allowed to buy their drugs?”
Only if they also get balancing information about the possible side-effects of pregnancy and birth. Including accurate information about the relative probabilities of the various risks.
Rebekka: I think crystal shard was trying to highlight just how ridiculous abortion-picture laws are, by drawing an analogy with treatments unrelated to reproductive health.
For example, how would things go if the government enforced a law that all people prescribed antibiotics should be shown a series of close-up photographs of antibiotic allergy rashes, anaphylaxis, Stevens-Johnson syndrome, someone vomiting, severe liver failure, Clostridial diarrhoea, and an MRSA carbuncle, before being allowed to have their prescription processed? And then forced to go home and wait a day or two to think about things before coming back and seeing another pharmacist? For a start, everything would grind to a complete halt, and pharmacies would need twice or three times the staff – which is part of the point of these anti-abortion laws.
A couple of years back I had a tooth abscess that in a day blew up from a small swelling on the gum by the tooth to a mass on the side of my face from the jawline to the eyeline, roughly the volume of an orange, and making it hard to speak.* I’d have been THRILLED with the idea of waiting another 48 hours before getting it treated.
I’d never inflict that on a woman facing something as severe as a pregnancy/abortion choice.
Then again, I’d never have to wait, because tooth abscesses can happen to men.
Yes, Lauredhel. Thank you. That is what I was attempting to illustrate with the question.
lilacsigil–I believe someone could become certified as a pharmacist without ever fulfilling a prescription for an actual person. But I am not willing to argue this point; I am merely trying to create an analogy so that the entire population might understand what it is like to be a woman threatened by the conscience clause.
SunlessNick: You probably also wouldn’t have to go interstate to find a dentist, or fight your way through screaming protestors, or worry about being bombed while you’re in the chair.
crystal shard – not in Australia. There are compulsory work placements throughout the course, plus a qualification year afterwards. But the analogy fails because there is no social support for the Christian Scientists’ cause, while there is strong social support for those who wish to impose their birth control ideology on others, hence the need for legal protection for patients.
I sort of feel like I’m missing something, because I think this is exactly where the analogy succeeds – in pointing out the hypocrisy of societal support for Christianist conscience clauses, and in pointing out why those clauses are problematic and dangerous. Unless the conscience-clause folk would also support Christian Scientists refusing to prescribe or dispense or refer for medicines, and a whole raft of other unlikelier possibilities (A public-hospital scientologist obstetrician who refused to provide analgesia under any circumstances? A rural pagan pharmacist who would only dispense herbs?), then the inconsistency is, or should be, clear.
Unfortunately, I have known of general practitioners who refused to prescribe psychiatric medication (even refills for those away from their usual doc), and subjected people to a religious lecture on the topic. It’s scary stuff.
“A couple of years back I had a tooth abscess that in a day blew up from a small swelling on the gum by the tooth to a mass on the side of my face from the jawline to the eyeline, roughly the volume of an orange, and making it hard to speak.* I’d have been THRILLED with the idea of waiting another 48 hours before getting it treated.”
Um. There there?
Oh. I thought the Christian Scientist thing was an excellent analogy. If we’re really making the point that no one ought to be forced to provide care antithetical to their religious beliefs, then whether or not this is a real scenario doesn’t matter, the question is ‘Would you object to a Christian Scientist refusing to provide treatments (such as blood transfusions) on the grounds that it is antithetical to their religious beliefs’. If not, well the justification seems not to stand.
And P.P…I think Sunless Nick’s point is that he did not HAVE to wait, and that no one ought to have to wait when they’ve made their decision on how to proceed with a medical treatment of an issue that is affecting them. Again with an analogy that works because it is different.
I have never had to do so little work to defend a position! Thank you very much for understanding and arguing this idea.
lilacsigil–I didn’t want to argue that point because I didn’t want to actually have to further a dystopia in order to wake people up. I know that inducing fear in others is more potent when the object feared is realistically possible, but I didn’t want to induce fear so much as spread an awareness of what women experience.
I think Sunless Nick’s point is that he did not HAVE to wait, and that no one ought to have to wait when they’ve made their decision on how to proceed with a medical treatment of an issue that is affecting them.
Precisely. Hence me saying this:
“I’d never inflict that on a woman facing something as severe as a pregnancy/abortion choice.
Then again, I’d never have to wait, because tooth abscesses can happen to men.”
You probably also wouldn’t have to go interstate to find a dentist, or fight your way through screaming protestors, or worry about being bombed while you’re in the chair.
No, definitely none of that either.
@FP – I really hope I don’t come across as being so intellectually incompetent that your immediate assumption is that I just didn’t *get* the point he was making.
Seriously, there is no need to explain it to me. I just resent seeing an entire paragraph about a dude’s toothache, suddenly pop up in a thread about abortion rights.
So while obviously the point made *sense* to me, it offended my feminist sensibilities, something he might have picked up on if left to figure out my response for himself.
Enjoy your cookie, Nick.
You seem awfully sure that SunlessNick is a man. I’m not, and I don’t think it matters either.
I’m not at all sure why it matters so much to you to belittle what I thought was a very valid point – that neither men nor women have to wait for treatment for a raging abscess because that is something that happens to men too.
Making sure that the description of the abscess pain was a vivid one seemed less about getting a cookie and more about making a writerly impact, to me.
Well PP, I thought given that the other option was unnecessary rudeness that a misread was a reasonable interpretation. I stand corrected.
FP – So you thought I’d prefer to be considered stupid than rude??? Really? Thanks sister.
Rudeness is sometimes necessary to make I point I think, and I believe I *am* allowed to make one. I don’t much value politeness, but if SunlessNick wanted to then SunlessNick could have taken it up with me independently.
tigtog -“You seem awfully sure that SunlessNick is a man. I’m not, and I don’t think it matters either.”
It matters very much to me if a person who is participating in a discussion about abortion rights is a man or not. I wouldn’t have thought I’d need to defend that position here, but there’s me put in my place I guess.
SunlessNick, if you are a woman then my sincerest apologies.
P.P., please chill. We all misread at times, because we all have cognitive blips. No-one is immune, no matter how clever they are, so there’s not necessarily an implication of “stupid” except, apparently, to you.
It matters far more to me whether a person is supportive of abortion rights. SN is supportive of abortion rights.
I’m not interested in a pissing contest.
tigtog, I am chilled. Also, as an outspoken feminist, I’m tired of being told to chill.
What made it’s way up my nose, was FP jumping in to “explain” Nick’s post to me. I’m not an idiot. I got it. I’m also sensitive about class condescension.
I also get that SN is supportive of abortion rights; that’s not what I’m on about here.
Even the most well-intentioned allies can benefit from having obscure expressions of privilege pointed out to them and it harms the feminist cause to shield them from that, assuming as I am that SN is in fact a man. If not, then I’ve already apologised.
Jumping in with words like “stupid” and “idiot” that nobody else used does not appear to be at all chilled, P.P. And WTF with “class condescenscion”? You are an articulate commenter here – I have no idea about your socioeconomic class, yet you assume that this is a factor in play.
Regarding your rudeness to SN: where I disagree with you is in the perception that SN’s tooth abscess story was an obscure expression of privilege even if your assumption about SN’s sex is correct. I’m just not seeing privileged expression there, and even if I did then I don’t enjoy seeing rudeness enter interactions between established commenters. SN is neither a newbie nor a troll, and deserves more consideration than such scolding.
[ETA to make one more point ~tigtog]
I reject this idea that those of us who see something objectionable should bite our tongues and let the person it’s directed at make an issue of it or not. That’s exactly what we object to with all those passively bystanding men when what we find objectionable is social expressions perpetuating rape culture, isn’t it? That they don’t speak up and say “hey dude, what you said is offensive”? That they just keep quiet?
An excellent thread.
Having worked for over 30 years in hospitals it never ceases to amaze me how a section of the medical profession, all of whom you’d expect to have a modicum of intelligence and able to think an argument through for themselves, grab hold onto the most simplistic and emotive aspect without thinking it through.
Surely the very, very first stop is to do no harm without fear or favour or inserting your own moral beliefs. Human beings are autonomous beings and we are able to determine for ourselves what harms us. The power to relieve or inflict suffering regardless of what a client wishes goes to the head of some. It is not for another agent not appointed by us to determine what harms us, especially when that agent has a different belief system to our own.
On practically a daily basis medical staff is confronted with perhaps self inflicted crisis that fly in the face of your own values and beliefs. It would not be tolerated to refuse treatment, why in the case of an unwanted pregnancy is this somehow OK?
I’ve heard medical personnel pompously declare they will never participate in either abortion or voluntary euthanasia, but blightly up the morphine infusion without prior consultation that this will hasten death. It’s just a ‘side affect’ of pain treatment!
I’ve seen medical personnel without a thought of the consequences do procedures like, just to give one example, taking blood from feet of vascularly compromised diabetics, yet make statements on ‘doing no harm’.
And on the issue of the catholic doctor not inserting IUD’s, but prescribing the contraceptive pill, I say ‘What the fuck? What kind of rationalization is that?’ Who is he to determine to what degree he is going to aid and abet in my sinning? Because that is what it is all about. Somebody else deciding how much you are allowed to sin by their own creed, not yours, their own.
So, that was my little rant. This issue really inflames me!
“Jumping in with words like “stupid” and “idiot” that nobody else used does not appear to be at all chilled, P.P.”
That was only after you used the term “pissing contest” though. My original clarification was worded far more mildly than that yet it was still dismissed as invalid. I thought I had a relevant point to make, even if SN does outrank me as a commenter. Oh well.
Can I also just point out that even those from the poorer classes are capable of being articulate. The assumption that they would not be is an example of the unexamined class privilege that seems to infect so many feminist/feminist-friendly blogs and forums.
I realise I’m coming from a totally different viewpoint here, and probably not making myself terribly clear, so I’ll just shutup about it for now.
peace out.
@ P.P.:
PP, I did not use the term “pissing contest” until #41. You were using terms judgemental of intellect before that:
And now you’re suggesting that I “rank” commenters instead of responding to what has actually been said? No, objections have been made to what you actually said in this thread. That’s all.
Of course: articulating concepts is all about
articulationeducation (whether institutional or self-directed). As an Australian, anyone with an education that leads to a sophisticated vocabulary is pretty much middle-class, which pretty much includes all the commenters here. Class is not just about money.Or else it’s just about you misunderstanding the point I was actually making.
PP a misread comment is not an uncommon thing on any blog, and is certainly not a mark of stupidity. Your initial condescending to Sunless Nick was fairly aggressive to someone trying to make a good point, and I couldn’t quite see why someone would be aggressive if they’d read it that way. And I did not want to assume.
I do not consider people who’ve misread the point of a comment as idiots. Do you? If you do I’d say that makes you the person with class condescension issues. And please do NOT assume to know my ‘class’ – none of my family before me was educated past year ten, every male on both sides of my family are alcoholics who drink the family money and keep everyone in fear, I grew up in a part of Sydney where kids got stabbed. I have had the good fortune to go to University and to try to escape some of that, but it’s not as though that’s ‘gone’, I still have to negotiate my criminal alcoholic father, and the fucked up family dynamics, and class is inflected through so much of our lives, like the debt I had to go into just to leave home, like nothing having been paid for by my family since 15. So it really shits me to have someone I don’t know making massive assumptions (allegedly in objecting to what you saw as an assumption although it was nothing of the kind) and to start wielding class against me for a comment that was merely a reminder that Sunless Nick was not necessarily making it about his/her experience. I am sorry that I didn’t think to spell out that I don’t think you’re ‘intellectually incompetent’ (even though I don’t talk like that or think like that) before commenting, it’s because I did not think that you were or that that had anything to do with the issue of whether you might have misunderstood.
Anyway…someone in there did try to get back to the topic of the thread.
Crikey is SN some kind of protected species here or something? A sacred cow? I said three words to zir.
tigtog-class is about so much more than either education or money, and it can’t be assumed that I belong in a certain class division just because of my vocabulary. None of my vocab came through going to school. After a sporadic attendance record I left school (and home) before I turned 15. My vocabulary is a result of the simple ability to listen and sheer will power and self-determination to overcome social obstacles.
fp-I apologise for not being clearer with the comment about class condescension. That was not aimed specifically at you but rather at the general vibe that I often feel here.
I have no wish to play the “my upbringing was worse than your’s” game with you. I’ve suppressed most of mine, anyway.
Now maybe we should all chill. Perhaps “established” posters could be labeled as such so I know who exactly I’m subordinate to.
The dialogue is no longer about SN. You’ve quite successfully derailed the thread to make it All About You.
For the record, I’m not one to judge anybody else by one blogspat in one thread. These things happen to all of us (I’ve certainly been in a few at various sites), and interactions on other threads need not be unduly influenced by what has happened on this one.
You were right.
The reason I brought up a tooth abscess was because of its triviality comparative to a pregnancy, and that even so, no one would ever have made me wait to think about getting it treated. I meant it as an indication of how unconscionable these waiting clauses are. Sorry that I wasn’t clearer about that.
Certainly I didn’t want to cause an argument.