Faking Conscience

Patricia Nell Warren’s Left Field

Starting with the American Revolution, the Quakers and others who believe that war is immoral gradually won their legal right to avoid active combat duty. Today the principle of genuine “conscientious objection” has been hijacked by ultraconservative rightists in the healthcare field. They’re using it to claim their perceived “right” to refuse any care, drugs or medical procedures that they see as immoral. “Objectors” include doctors, nurses, pharmacists, EMTs, hospitals, clinics, and insurers.

The trend started with Catholics who objected to state laws and federal regulations requiring them to assist with abortions or birth-control services. With other faiths joining up, this “conscientiousness” has some broader, uglier expressions, and possibly sets the stage for new attacks on care for people with AIDS.

Some state legislatures are considering bills that grant a legal “religious freedom” to deny medical care. Wisconsin passed such a bill, which the governor vetoed. In Michigan, that bastion of Republicanism, the Conscientious Objector Policy Act recently sailed through the House, and will doubtless pass the Senate and be signed into law. The Act is part of a four-bill package that protects healthcare workers and insurers from being fired or sued for refusing to perform a procedure, fill a prescription, or cover treatment for something they object to for moral, ethical or religious reasons. Supporters of such legislation insist that they’re guarding a constitutionally guaranteed right. But the Michigan bill set off a nationwide clamor. One commentator warned: “Health-care providers are constitutionally free to hold whatever religious and ethical views they wish. [But] they do not have a right to inflict those beliefs on people coming to them for medical treatment.” Rep. Chris Kolb (D-Ann Arbor), Michigan’s first openly gay legislator, warned that the package doesn’t ban discrimination based on sexual orientation—opening the door to denial of treatment to gay people. Rep. Jack Minore (D-Flint) said, “I think it’s a terrible slippery slope upon which we embark.”

A slippery slope indeed, where it’s suddenly legal to violate the Hippocratic oath. Activist physician Gus Krucke [A&U, February 2004] of Texas, a fearless campaigner for patients’ rights, wrote a sarcastic open letter to Michigan legislators, making like a redneck who was delighted to find Texas-style bigotry flourishing up North. He wrote: “Honey….If them doctors who hate homosexurals [sic] are able to get you to vote for a bill that is full of prejudice, I must say that I am teary eyed; you done everybody so proud!”

Real conscientious objectors don’t want to kill or harm others, while today’s neo-objectors don’t mind killing or harming others by default. They tell us that no one has the right to harm unborn babies—then they reserve for themselves the right to harm other people whose actions offend their personal beliefs. Like the Texas pharmacist who refused to sell morning-after pills to a rape victim. Like the practitioners who—according to PFLAG—disapprove of transgenderism so they refuse to provide transgendered people with care for cancer, work-related accidents, even routine checkups.

As for AIDS treatment—a recent national survey reported that half the nation’s primary-care doctors would refuse to treat HIV-positive patients if they could. Shockingly, some Americans support such sentiments; a 2002 Kaiser survey showed that twenty percent feel that doctors should have the right to refuse treatment to AIDS patients. Recently in Louisiana, this attitude devastated an elderly HIV-positive stroke victim as six nursing homes in a row refused to admit him. The old (1990s) excuse for refusing treatment was fear of HIV transmission, but today more people are feeling socially comfortable with expressing a moralistic judgmental reason for refusals.

The AMA warns that doctors who refuse to treat AIDS patients could lose their licenses. “The practice of medicine is a privilege granted by society; it is not a right,” warned the Journal of the American Medical Association. But what will the AMA do when government itself sets the stage for legal denials of care?

Neo-objectors seem to have forgotten an important parameter of real conscientious objection. The U.S. Armed Forces allow you to follow your conscience and not fire bullets, but you have to serve your country in some other, peaceful way, like conservation or educational work. Meanwhile you are rigorously screened to make sure you have real convictions and aren’t malingering. Failure to convince the brass means that you might go to prison. Unlike the real COs in uniform, these neo-objectors are getting a free ride. They don’t risk prison. They don’t have to be screened. They get to force their beliefs on a lot of other people. And they don’t have to serve their country in other ways in exchange for getting off the hook.

Further reading:
History of conscientious objection at:
www.academy.umd.edu/publications/NationalService/conscientious_objectors.htm

Patricia Nell Warren, author of fiction bestsellers like The Front Runner, also writes provocative commentary. Her writings are archived at www.patricianellwarren.com. Reach her by

e-mail at patriciawarren@aol.com.

June 2004