Health care: Not value neutral

		Eye on the  Capitol  Kathy Markeland

Abortion has been legal for 30 years. Over this same period, advances in technologies that enable the extension of life and others that also involve the termination of newly formed life have presented health care workers with new moral and ethical challenges.

As the U.S. Bishops' Ethical and Religious Directives for Catholic Health Care (ERDs) caution, "What is new can either be an opportunity for genuine advancement in human culture, or it can lead to policies and actions that are contrary to the true dignity and vocation of the human person."

Early on, states responded to the legalization of abortion by enacting some form of "conscience protection" for health care workers. Now, in response to continuing changes in the medical field many of these states are reviewing these conscience protections laws. Here in Wisconsin, the Legislature is currently considering two proposals to expand conscience protections for health care workers.

Proposals

Under current law, health care workers and health care institutions are protected from discrimination and liability for refusal to participate in abortion related activities or sterilization procedures if those objections are based on moral or religious grounds.

While differing in the specifics, the two bills currently under consideration would expand protections to include additional health care professionals, and the scope of the protections available to health care workers to address new procedures and medical treatments, such as the use of fetal tissue and embryonic stem cells.

Opposition to these proposals has revealed some differing perceptions about freedom and the autonomy of patients.

Consequences

One of the questions offered by those opposed to health care conscience protection is, "Whose conscience?" This query presumes that by enabling health care workers to act on their beliefs, somehow the freedom of the patient is restricted.

This oversimplifies the physician-patient relationship, casting the health care professional as a mere service provider and the patient as a consumer. In this consumer-driven economy, the customer is always right. But is that truly the case?

The reality is that within the medical sphere, the services that are provided have life and death consequences. Few interactions between a patient and their health care provider are totally value neutral.

Indeed as the ERDs emphasize, "The relationship of the person seeking health care and the professionals providing that care is an important part of the foundation on which diagnosis and care are provided. Diagnosis and care, therefore, entail a series of decisions with ethical as well as medical dimensions."

Embracing freedom

It is not a matter, therefore, of an either/or relationship where the conscience of one of the two parties is disregarded. But instead, particularly when life and death are at stake, the consciences of both the provider and the patient should be respected and protected.

Just as a health care provider cannot obligate a patient to pursue a particular course of treatment, a patient should not be able to obligate a health care worker to participate in an action that they believe to be contrary to the value and dignity of human life.

There is a distinct difference between having the "right to make a choice" and compelling someone to be complicit in that choice regardless of their moral convictions to the contrary. Fundamentally, conscience protection is about embracing freedom, not denying it. For as the Holy Father has stated, "Freedom consists not in doing what we like, but in having the right to do what we ought."

Kathy Markeland is associate director of the Wisconsin Catholic Conference.