Wednesday, November 6, 2019

Conscience protection rules struck down by US federal judge.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A federal judge in New York  struck down protections in law for medical professionals who conscientiously object to assisted suicide

Doctors may be forced to refer patients for assisted suicide.

When discussing the issues of euthanasia and assisted suicide with medical professionals, the issue of conscience protection is always a concern. 

Physicians who believe that it is wrong to kill patients by lethal injection or prescribing lethal drugs have lost, today, clear conscience protection.

In May 2019, the Trump administration announced an order to protect conscience rights for healthcare workers. CNBC reported:

In a release last week, the Health and Human Services announced the issuance of its final “conscience” rule, which it said follows President Donald Trump’s May 2017 executive order and his pledge “to promote and protect the fundamental and unalienable rights of conscience and religious liberty.”
Today, a federal U.S. District Judge Paul Engelmayer struck down the Trump administrations conscience rule that protected medical professionals from participating in medical procedures that they consider to be immoral or simply wrong.

The Trump conscience rule protected medical professionals from participating in many medical activities including euthanasia and assisted suicide.

According to an article by Stephanie Armour who's article was published in the Wall Street Journal:

Nineteen states and family planning groups had sued to block the Department of Health and Human Services regulation that sought to expand enforcement of protections for medical workers with moral or faith-based objections to medical procedures such as abortion, assisted suicide or sterilization at hundreds of thousands of health organizations.
Armour reported New York Attorney General, Letitia James as stating:
“The refusal of care rule was an unlawful attempt to allow health-care providers to openly discriminate and refuse to provide necessary health care to patients based on providers’ ‘religious beliefs or moral objections,’
The Trump administration must appeal this decision based on a false understanding of the role of health care providers. Doctors should not be forced to participate in legal healthcare services that many healthcare professionals morally object to, such as assisted suicide.

The courts and government should not have the right to force someone to participate in an act that the person considers morally objectionable. Physicians refuse to participate in capital punishment. In the same manner many physicians refuse to participate in assisted suicide.


Batshit Burner said...

You're arguing that a doctor's conscience is being violated even though they don't have to prescribe the meds themselves; that simply telling the patient to see another doctor should not be considered acceptable medical practice?
Medical practice standards are set by each state. There is little justification for having the Federal government oversee them, except insofar as political points can be made with religious fundamentalists --- something that government was never intended to do under our Constitution.
A doctor's refusal to accommodate a request for assisted suicide is understandable. Allowing him to abandon his patient by not referring him to another doctor --- under the guise of "conscience" --- is inexcusable.

Amy Hendricks said...

As a specialist physician in a rural area, I often refer patients to other physicians for care that is beyond my scope of practice - to make a diagnosis, perform a procedure, or improve their quality of life. I do not refer patients to someone who will deliberately end my patient's life. Abandoning my patient, however, would imply that I am longer caring for them in any way, including those areas that are within my scope and capacity. If a patient desires death, I will continue to provide care that improves their quality of life to the best of my ability, until the time of his or her death - regardless of how that death comes to pass.

Refusing to facilitate a patient's death has never constituted abandonment, and it never will.

Alex Schadenberg said...

Thank you for your comment. You are a caring physician.

Dr. Arnold Voth said...

The argument that simply referring a patient to another physician for a procedure the physician feels is morally and ethically wrong involves no moral responsibility for the referring physician is constantly trotted out by a variety of writers, most of whom should know better. It is nonsense. A physician is ethically responsible for the referrals he/she makes. If a referral is made either for a treatment that is not good medicine or perhaps to a physician who is clearly incompetent for the problem in question, the referring physician will be held ethically and legally responsible. This responsibility doesn't vanish when the procedure in question is something like an abortion or euthanasia. If this referral violates the conscience of the referring physician, he is morally and ethically responsible. He is NOT just an uninvolved bystander. arnold voth md

Karen Dwyer said...

Thank you, Amy Hendricks, for your well-articulated perspective of what constitutes true patient care.

In my mother's case, in hospital and with no assisted suicide provisions even in state legislature, she was badgered by one particular doctor relentlessly. That doctor kept trying to get my mother to say that her life was not worth living and that she was more scared of pain than she was of death. That particular doctor wanted my mother to stop having blood transfusions and die, with overdoses of morphine if need be.

My mother insisted that she was not afraid of pain or death, and that she wanted to live. She lived for several weeks after that, well beyond the length of time that had originally been suggested. In the last hours of her life, she was not conscious, and we do not know whether she was "assisted" into death against her will.

These are the things that made her life more comfortable: having a capable nursing sister draw blood for cross-matches (instead of junior doctors who REFUSED to listen when my mother told them they were trying to take blood from a collapsed vein); having blood transfusions; having a shunt inserted and not removing it on the occasions that my mother came home from hospital; having nappy rash cream for chafing; having a sippy cup; having sufficient pillows so that she could sit up; having a fan in her room; having ice chips; having family and friends visit; having smaller amounts of food more often; having visits by the chaplain or volunteer hospital visitors; having her hair brushed; having moisturiser rubbed into her skin; having access to the gardens; having audio books and DVDs; and receiving prayer, cuddles, photos with her loved ones, flowers and momentos. Being able to talk about the process of death, without hurrying that process, was an incredible relief for my mother.

Much of what made my mother's life have dignity and comfort came from the sort of care that should have been available in a hospice but there were no hospice places. We were able to take care of the 'small things' that are incredibly important - personal hygiene; nutrition; and gentle sensory experiences - in a public hospital because there were caring nursing staff who looked after the strictly medical while we looked after the 'small things'.

Refusal of abuse is NOT the same thing as refusal of care. Forced speech, forced action, and forced referral are horribly reminiscent of the abuses of the state in Europe in the 1930s and 1940s, the abuse of mentally ill people in institutions like 'Bedlam', and the medical-experimentation-without-consent that still occurs in some prison populations.

I'm extremely grateful to the professional medical staff like yourself (and those who actually cared for my mother) who enriched the end of my mother's life and gave us all much more than we had anticipated.

Batshit Burner said...

"Conscience" is a pretty broad exception. Do the doctors posting here believe that it encompasses the right to refuse a patient any treatment they claim offends their sense of morality? Would they, for example, defend the conscience rights of a physician who refused to treat African-Americans because of some arcane "sincerely-held" religious or philosophical belief? Would they defend a physician who refused to recommend or make a referral for contraception on religious grounds, even if there was a bona fide risk of the patient's injury or death in childbirth? Why should these situations differ in any way from a referral to a doctor who will arrange assisted suicide if the patient is terminally ill and wishes to die on his or her own terms?
If society permits totally subjective standards to replace generally accepted standards of medical care the quality --- indeed, the essence --- of the doctor-patient relationship is diminished, if not entirely negated.

Edison said...

Edison 11 Nov 14:20
I would like to refer to the freedom of conscience and behavior in accordance with anim.
When we speak of a Christian conscience, it should be taken into account that it is inseparable from God's Word.
Can then accuse me of conscience when I live my life in accordance with God's Law? Is it not rather that he accuses me when I cross them, indicating that I do not follow the teaching of God's Word. Influencing a believer to act contrary to his beliefs, principles, and teachings from the Holy Bible
it is tantamount to telling him to oppose God's Word and to respect the human word more than God's Word.
Such activities will not bring anyone anything good, because God's Law flows from His Holiness as well as from the love of his creation and always has his good in mind.
Once before the court, the apostles said: "But Peter and John answered and said unto them, Whether it be right in the sight of God to hearken unto you more than unto God, judge ye."
Acts 4:19.
And the Lord Jesus gave such a recommendation:
"And he said unto them, Render therefore unto Caesar the things which be Caesar's, and unto God the things which be God's."
Luke 20:25
This is a very good demarcation.
However, the problem arises when what the imperial violates God's commandments and demands that he abide by his guidelines. The word "doctor" in the name itself contains the nature of his work and this should not be changed.
To sum up, I believe that a doctor should have the right to proceed in accordance with
a conscience that is the expression of his Christian beliefs, not only in euthanasia or abortion, but also in not serving as a signpost, indicating who can do it in killing. Sad is the picture in which the laws and principles chosen by the majority
clearly indicate that Christian values ​​are rejected.
Is it right in the name of the bad to corrupt the good?
Is it not better for people who feel
unnecessary and rejected to bring love and hope instead of helping to destroy their lives.
Is God's blessing to a people who respect His Laws,
meaningless? If the good that God wants to give
I need the right ground.

Carol O'Brien said...

Dear Karen, Thank you so much for your post about caring for your beloved mother in the final days of her precious life. This is exactly the care we gave our precious mother when she was diagnosed with cancer and was certified through Medicare for hospice care. At that time her oncologist felt she had a few weeks to live. My brothers and sister-in-law determined that as long as possible, we would care for her in her home. We had a hospice team of nurses and aides that were a blessing to us and mom. I requested an "air" mattress for her hospital bed and she never had a bed sore. This team helped with bathing and other medical needs. We were able to pay caregivers to help so we could still work during the day. My sister-in-law came from out of town every two weeks and stayed with mom for a week. We prepared meals she enjoyed and brought her things to read, which she enjoyed. Our beloved mother passed away in her own bedroom very peacefully eleven months later. We thank God for the blessing of caring for our mom as she had cared for us all her life.

Anonymous said...

Does the life protecting power of attorney need to be signed in front of a lawyer?