The Conscience Clause, Death Panels, and Health Care Reform

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Ohg Rea Tone is all or nothing. He is educated and opinionated, more clever than smart, sarcastic and forthright. He writes intuitively - often disregarding rules of composition. Comment on his posts - he will likely respond with characteristic humor or genuine empathy. He is the real-deal.

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The Conscience Clause, Death Panels, and Health Care Reform

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The idea of legalizing a medical conscience for Health Care providers originated with the debate around abortion.  The idea was simple enough: If a physician was morally opposed to abortion, he should be allowed to follow his conscious.  Fair enough.  But the conscience clause evolved under the Bush Administration, growing nasty tentacles of religious dogma. The Bush ideologues expanded the conscience clause to include giving advice on issues ranging from reproductive health to vaccines.

So what if a physician is a Scientologist and believes in faith healing?  What if the physician is a 7th Day Adventist and believes disease is God’s punishment for sinful behavior?  What if the Scientologist does not believe in medication to treat depression – an idea made famous by Tom Cruise when criticizing Brooke Shield for taking medication for postpartum depression.  What if the physician is a Quaker who does not believe in vaccines for anything, including polio, smallpox, and the flu? I don’t know what Scientology or Adventism, or Quakerism believes – I do know that each faith has particular ideas governing health care.

The Obama administration is moving to remove the Bush era excuses for not delivering complete health care opportunities.

According to CNN:

Many health-care organizations, including the American Medical Association, believe health-care providers have an obligation to their patients to advise them of the options despite their own beliefs. Critics of the current rule argue there are already laws on the books protecting health-care professionals when it comes to refusing care for personal reasons.

Dr. Suzanne T. Poppema, board chair of Physicians for Reproductive Choice and Health, said, “Physicians across the country were outraged when the Bush administration, in its final days, limited women’s access to reproductive health care, … Hundreds of doctors protested these midnight regulations and urged President Obama to repeal them quickly. We are thrilled that President Obama took the first steps today to ensure that our patients’ health is once again protected.”

The idea of a conscience clause takes on new meaning with the idea of “Death Panels.”  Sarah Palin and her allies claim that the Obama Administration is advocating Death Panels – small groups of SS Soldiers who will decide which people live and which people die.  Of course – the idea is absurd, has been debunked by every sane person who knows anything about the truth, but continues to haunt rational debate on health care in America.

Conspiracy theorists love ideas like Death Panels.  While the idea seems absurd to thinking Americans, we need only look back to NAZI Germany for verification that an all-powerful government can engineer horrendous tragedy among the masses.  But this is not NAZI Germany and Obama is not Hitler.  Some would argue that last point – but they are the right fringe of the Republican Conspiracy Party.   The NAZI experience continues to baffle civilized man – how could so many people participate in the extermination of their fellow man?

So let’s make this personal.  My father died last year at age 85.  He had prostate cancer at age 69 and the urologist who operated told him he might have another fifteen years.  At age 84 his health became a daily issue, and he was towed to the hospital five times by an ambulance.  It was obvious to all that he was in his last days.  On his last trip to the hospital his physician counseled that his major organ systems were failing and there was little to be done other than to keep him comfortable.  The physician offered Hospice. (You can read about Hospice here, or here, or here.)  Essentially, hospice is end-of-life care.  It is not the denial of medical treatment.  The implementation of hospice treatment is not decided by a Death Panel.  Most modern hospitals practice a team approach – that is to say they employ a family physician, a specialist if necessary, nurses, social workers, chaplains, and a variety of medical therapists, like physical therapy or respiratory therapy.  Is this what Sarah Palin calls a “Death Panel?”

My father’s hospice care was to begin the day after he left the hospital – but he died.  That last day at the hospital, before my father’s death, my mother was relieved that she would have help in her home.  She knew her husband of 62 years was dying.  She also knew that, at age 85 herself, she would not be able to take care of him.  I have several brothers and one sister.  Most of them are religious loonies – but none of them denied the accurate assessment of my father’s condition.  None of them denied the value of Hospice to both of our parents. None of them even considered the possibility that a Death Squad had just rendered a death sentence on our father.

I have been listening to this absurd debate for several weeks.  I have not written about it because it just seemed so absurd.  The idea of a Death Panel is just so crazy that I could not bring myself to give any time to the debate.  But the idea has persisted.  Town Hall meetings have erupted in unruly protest over this issue.   Adolph Hitler left errant prints in the sand throughout his life – his life course was toward destruction.  What are the prints in Obama’s life sand?  What in his past suggests in any way that he is a man of bigotry, hatred, prejudice, and destruction?  What in Obama’s past suggests he would somehow enjoy the death of another person?  Nothing!  Not one thing.

The idea of a physician having a conscience is a given.  Actually, only people with a conscience should ever become physicians.  That is not always the case (Witness Elvis and Michael Jackson and Octo-mom).  The reality is that most physicians do good work.  They practice professional ethics.  They work hard to keep up with fast changing medical technologies.  And they do not all agree on these same ethics.  That is not a bad thing.  What is a bad thing is when a physician allows his fringe religious faith dictate his professional ethics.

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