In my line of work, the battle between what is right and what is wrong is one often fought — and no, I’m not a lawyer. I am, however, a healthcare professional, and though what is right and wrong is seemingly black and white, the reality is much more complex. Though those who work within the field are constantly striving to do no harm, there is no avoiding the human complexities of bias and opinion. This creates an interesting dichotomy, especially when the laws which dictate the work are created by rulemakers with no formal background in the field.
Since this past election cycle, the political climate has been nothing short of disastrous, though it was an unforeseen event when Trump’s administration began to swim in the deep, dark, depths of medical ethics. It began when Trump no longer required health plans to pay for birth control — a disastrous hit to women everywhere and the undoing of work done by the Obama administration. Unsurprisingly, the enactment of this new law was about to deliver an even more cataclysmic hit. As of January 18th, 2018, Health and Human Services (HHS) announced that they would be forming a new division titled the “Division of Conscience and Religious Freedom, ” which according to HHS has been formed to “restore federal enforcement of our nation’s laws that protect the fundamental and unalienable rights of conscience and religious freedom.” Never once in my career did I think that the battle of religious freedoms would ever be brought to the medical forefront, and never to this extent. While it may seem like an outlandish allegation to claim that Trump’s administration is to blame, HHS Secretary Hargan himself actually stated “President Trump promised the American people that his administration would vigorously uphold the rights of conscience and religious freedom. That promise is being kept today. The Founding Fathers knew that a nation that respects conscience rights is more diverse and more free, and OCR’s new division will help make that vision a reality.”
Though this creation is seemingly unalarming, to those who work in the healthcare field, it’s a harrowing indication of a lack of separation between church and state. It’s a burden taken upon those who work in the field that they will do no harm, and will do everything in their power to save those whom are in the realm of saving. While religion is morally integrated into those who practice it, the innate desire to help those in need of aid is usually a far greater cry. Though HHS claims that the new division will not infringe upon the current federal laws in place, such as Section 1557 of the Affordable Care Act, which makes it illegal to discriminate against patients due to gender, there is seemingly no word on the protection of sexual orientation or protection of those who identify with a different gender than their assigned sex. The true meaning of this new division seems slightly up in the air, and the website seems to cite different reasons for the division’s creation. Under “Conscience Protections,” the Division of Conscience and Religious Freedom states, “The ORC protects and enforces laws and regulations that protect conscience and coercion on issues such as abortion and assisted suicide (among others) in HHS-funded or conducted programs and activities.” However, overall the HHS seems to be adamant that this new division has been created to protect others against unlawful discrimination on the basis of religion.
While it morally may make sense to not force a nurse who has been raped to work with a convicted rapist brought into LA County, how far can this morality bend? More alarmingly, how will the bias of those enforcing the rules be avoided? I know that morality and religion can never be used in the context of black and white. Furthermore, I understand that religious freedom is a tremendous fundamental right bestowed upon us by our forefathers. However, when someone’s life is quite literally in your hands should the decision to refuse their care truly be based on one’s own religious practice?
For more information:
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Section 1557; https://www.hhs.gov/civil-rights/for-individuals/section-1557/index.html
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Division of Conscience and Religious Freedom Homepage; https://www.hhs.gov/conscience/index.html
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A copy of the modern Hippocratic Oath; http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html