NEJM editorial re: conscience clauses

[sldavis]

There is an editorial in this week's New England Journal of Medicine that I think does a pretty good job of summarizing the stance of health care professions in the debate over conscience clauses and contraception. The full-text is free on the NEJM web site, and I encourage anyone interested to read it. There is also an audio file of an interview with the author, which I admit I haven't listened to yet. This is becoming a big issue in medicine and pharmacy... we don't want to deny our colleagues their right to a "conscience," but more importantly we can't let their personal views interfere with providing medical care to our patients. If there is a law being introduced in your state to protect doctors and pharmacists when refusing to provide contraception, please contact your legislators to make sure there is also a clause to protect patients ensuring appropriate referral is always offered.
-SLD



The Celestial Fire of Conscience — Refusing to Deliver Medical Care
R. Alta Charo, J.D. NEJM 352(24):2471-3, June 16, 2005

...
Largely as artifacts of the abortion wars, at least 45 states have "conscience clauses" on their books — laws that balance a physician's conscientious objection to performing an abortion with the profession's obligation to afford all patients nondiscriminatory access to services. In most cases, the provision of a referral satisfies one's professional obligations. But in recent years, with the abortion debate increasingly at the center of wider discussions about euthanasia, assisted suicide, reproductive technology, and embryonic stem-cell research, nurses and pharmacists have begun demanding not only the same right of refusal, but also — because even a referral, in their view, makes one complicit in the objectionable act — a much broader freedom to avoid facilitating a patient's choices.
...
Accepting a collective obligation does not mean that all members of the profession are forced to violate their own consciences. It does, however, necessitate ensuring that a genuine system for counseling and referring patients is in place, so that every patient can act according to his or her own conscience just as readily as the professional can. This goal is not simple to achieve, but it does represent the best effort to accommodate everyone and is the approach taken by virtually all the major medical, nursing, and pharmacy societies. It is also the approach taken by the governor of Illinois, who is imposing an obligation on pharmacies, rather than on individual pharmacists, to ensure access to services for all patients.
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more...

http://content.nejm.org/cgi/content/full/352/24/2471