02/11/2009 01:06 pm ET | Updated May 25, 2011

HHS "Conscience" Regulation Still in Place

That meddlesome regulation encouraging health care workers to obstruct needed treatment considered offensive to their personal beliefs, went into effect January 19. It's still in place. I'm determined to continue blogging about this issue until it is repealed.

Congress, the administration, or both must act to restore the needs of patients to their rightful priority over the morality of providers. Click here to urge the administration and your representatives to scrub this bad rule from the books.

Understandably, the battle over economic stimulus is occupying everyone's attention. Fiscal conservatives insist the package contain more tax cuts. Compromising with them has so far had no effect on their votes. The belief system of the many conservatives just won't allow an "aye" vote to spend public money directly for job creation. Their belief that government just doesn't do this trumps the current need.

My point is this "conscience" rule is essentially the same issue. We're in a clash between ideologues and pragmatists --- people who place their own dogmatic beliefs above all--- and people inclined to rely on pragmatic solutions in times of need or crisis.

Pragmatists definitely follow a moral compass and hold strong beliefs and values. But when confronted with solid evidence that acting on their beliefs will not solve a crisis, pragmatists tend to ask, "What else could work?" and move in a new direction. Ideologues refuse to move on.

This is why the Refusal Rule --- called "Conscience Rule" by its proponents --- is so dangerous. It's like a big doggy treat for health care bulldogs who would love to sink their teeth into other people's health care decisions.

Many people responded to my first two blogs on this rule commenting that divergent beliefs are an infrequent problem. These people say it's unlikely that people with strong objections to certain medical treatments would choose to work in a hospital or clinic where the treatments occur.

Before this rule went into effect, that was probably true. But the stated purpose of this rule is to urge ideologues into action. It encourages them to go to work where they can impose their beliefs on the maximum number of medical patients.

It's right there in the original language of the proposed rule. It seems a New England Journal of Medicine article caught the eye of the people at HHS looking out for the nation's morality. The study reported on physicians who object on moral grounds to such things as contraception and an end-of-life emergency procedure known as terminal sedation.

Most physicians believe that even if they object to a legal treatment, they still have a duty to tell the patient it is available.. After all, how can patients make informed decisions about their various treatment options if their doctors refuse to disclose all treatment options? But a good number of morality-driven doctors said they don't tell patients about the treatments they find morally objectionable. The HHS authorities clearly wanted to protect them by establishing a provider's right to withhold crucial information.

A New York Times editorial enraged the HHS folk by stating that, "Any doctors who cannot talk to patients about legally permitted care because it conflicts with their values should give up the practice of medicine."

The HHS rule intends to change this by encouraging moral ideologues in every health care category to seek employment in the medical system and protect them when they refuse to provide treatments they don't like. The great "benefit" the rule makers cite is a newly "diverse" and "inclusive" workforce, "in which individuals from many different faiths and philosophical backgrounds are encouraged to participate."

These dogmatists want to fill our hospitals and clinics with workers who place their beliefs over the needs of their patients. The pragmatist in me says this won't work well for patients and I intend to keep hammering on Congress until the problem is fixed. Please join me.