When Moral Conscience Poisons Health Care

One of Bush’s last gifts to our nation was the Provider Conscience Rule, which protects anyone who works in a health-care facility and who doesn’t want to provide “any services or advice they find objectionable.”

Thanks to the Washington City Paper’s Sexist for picking this up: NPR’s Robin Young interviews a family doctor who regularly refused to prescribe birth control pills to unmarried women, and who recently resigned from the hospital where she worked after being pressured to do so. Dr. Michele Phillips has shady, shifting reasons for withholding the Pill – she first seems to imply that it’s not “medically indicated” for unmarried women – and the thrust of her argument is that birth control pills for single women lead to sexually transmitted diseases. 

Young points out the difficulty of relying on marital status when prescribing. Monogamous relationships often occur outside of marriage, and some marriages are non-monogamous. And these are not incidental considerations. Many women in the United States contract HIV within marriage. Phillips’s view of marriage as a magical, disease-free space is misguided and points to just how arbitrary and misinformed her “moral conscience” is.

Then, when Young asks her a tough question – as a pro-life physician, isn’t she interested in preventing abortions? – Dr. Phillips responds with an unrelated hypothetical situation about a healthy patient who, within a few years of visiting a doctor (and presumably receiving birth control pills?), contracts herpes and puts on fifty pounds.  The doctor’s rationale is hard to follow. She completely abandons the abortion question and seems to be making a case for the importance of communication and counseling in health care – she mentions the dangers of fast-food, the importance of exercise, and “prevention” as opposed to “damage control.”  

This all sounds good. Why not counsel your patient on all-around healthy living? Since Dr. Phillips seems to be preoccupied with sexually transmitted diseases, such counseling might include condoms along with birth control pills. “Why can’t you do both?” the interviewer asks.

At this point, Phillips betrays her true lack of interest in her patients’ well-being:

“Because I don’t need to. It is my right as a physician to not go against or violate my own conscience. And why should I violate my own conscience for someone else’s behaviors?”

You shouldn’t, Dr. Phillips. You should become the leader of a Chastity Pledge group if you believe in abstinence until marriage. Medicine, on the other hand, is the practice of understanding human behavior and human health, and how they can best be reconciled.  

Defenders of the Provider Conscience Rule may argue that patients who object to the objections of such providers are free to go elsewhere for medical care. But this argument ignores two things. First, acts of interference may not be as obvious as Phillips’s medical sabotage. A patient may go through the entire process of obtaining a prescription, only to find that the pharmacist won’t fill it. Not to mention emergency contraception, for which there’s often no time to get a second opinion, especially if you’re in the hospital after having suffered sexual assault.


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