A nurse at Mt. Sinai hospital in New York was reportedly forced to assist in an emergency second-trimester abortion, and is now suing. Predictably, the right is flipping out, and even blaming Obama. According to the story, which I can only find one version of (and that’s through an anti-choice Catholic news agency which bases the whole article on a lawsuit filed by an anti-choice organization), a woman came into the emergency room and had to have an emergency abortion — she was a “category II” patient, which means that the surgery had to happen within six hours. Details are spare, but according to the article — which only gets the nurse’s side of the story — the nurse was told that she had to assist in the abortion or she would be charged with insubordination and patient abandonment. She assisted, and now she is suing.
So, first, let me say that I don’t buy this article at face value and neither should you. But it’s an interesting story nonetheless, because it brings up a lot of the problems with conscience clause legislation. I happen to think that workplace accommodation for religious, moral or other belief is a good thing. I don’t think that nurses should generally be forced to assist in abortions if it violates a strongly-held religious belief. I think employers should do their best to make accommodations for a religious employee observing the Sabbath or important holidays. I think if someone voices a serious moral or ethical concern with working on a particular project, their employer should make the best effort to put someone else on.
But all ideals have edges, and I draw the line when you’re a health care worker and someone is dying in front of you. Should the hospital have done its damndest to find a different nurse to help out? Yes. Should it have tried to assemble a team of people who are actually interested in saving a dying woman instead of prioritizing her fetus? Yes. But have any of you been to an emergency room lately, or worked in one? Sometimes there just aren’t other staff members to be found, and in the meantime someone is seriously ill or dying. To have a nurse just standing there is pretty atrocious.
Cassy Fiano, the blogger at HotAir, has this to say:
My first thought is how cruel this is — to force someone to participate in something that they have such a strong moral objection to. If her supervisors knew of her objections to performing abortions for five years now, and then forced her to assist one anyways, then that seems to me like a petty, cruel thing to do. As explained in the article, the hospital is claiming that the patient was a Category II case, meaning the operation needed to take place within six hours. That would have been more than enough time to find a nurse without moral objections to perform the abortion. Yet instead, they sought out the Catholic nurse who they knew had moral and religious objections to abortion, and forced her to do it. That is cruel, and unnecessarily so.
Ah yes, the cruelty of forcing someone to violate their religious objections. So much less cruel to make an emergency patient sit and wait for six hours as she faces possible death or serious bodily harm!
The thing with emergency room categorization? It’s not a science. The six-hour window is part of a triage system; it means that this person isn’t going to die immediately, but she might die pretty darn close to immediately. The longer you wait, the closer death — or serious bodily harm — begins to creep. She’s not just sitting there in great health for six hours. Each of those hours, and the minutes within those hours, matter.
None of that is to say that you must grab the first nurse standing there if you know she objects to the procedure. Ideally, the hospital would have found someone else to assist. But if it wasn’t able to, then the life and health of a patient should be placed first.
Unfortunately, this is all too common and in a variety of ways. It’s mostly thanks to feminists who howl in rage if anyone has a moral objection against anything they feel is a “reproductive right”. Doctors and nurses who don’t want to perform abortions, pharmacists who don’t want to dispense the morning after pill or contraception… they’re all told that they’re required to do these things and if they don’t like it, to get out of their field. Organizations like Pharmacists for Life International find themselves the target of feminist wrath. And whether it’s regarding pharmacists, doctors, or nurses, the end point is still the same each time: it’s about restricting choice. This is America, where free-market capitalism is supposed to reign. A business owner can operate his or her business how they want to. They can sell whatever goods or products they want to — and likewise, refuse to sell whatever goods or products they don’t want to sell. Customers, meanwhile, are free to shop wherever they choose. If they don’t like a pharmacy that refuses to sell contraception, or a doctor’s office that won’t perform abortions, they can go elsewhere. Some people though — ironically, most so-called pro-choicers — don’t want people to have that choice, though. Abortion is legal, so therefore, all doctors and nurses must be willing to perform it, no matter what their religious and moral principles tell them.
For someone who loves capitalism and American rule of law so much, she doesn’t seem to have a sophisticated understanding of either.
First, health care is not purely a good up for free market exchange, not in the U.S. economic system. Second, a nurse is an employee and not a business owner. She has rights, but those rights are constrained by the requirements of her job. Third, medicine and pharmacology are regulated industries, and for good reason — they don’t have free reign to provide only what they want and to serve only those they like.
Hospitals don’t have to perform abortions, but they do have a legal obligation to protect the lives and health of their patients. If they refuse to assist a patient who is dying and needs an abortion to save her health and her life, they can be in a good bit of trouble. Nurses can have moral objections, but they still have to do their jobs, which means not letting patients die in front of them. If a religious vegetarian Hindu gets a job at a restaurant and then refuses to serve any customer who orders meat, his employer can probably fire him. If a religious Muslim gets a job at a bar and refuses to serve alcohol to customers, her employer can probably fire her. If a Scientologist gets a job at a pharmacist’s office and refuses to fill prescriptions, his employer can probably fire him. This case is obviously a little different — it’s not like the nurse got a job at an abortion clinic and then refused to help — but she did get a job in an emergency room, where it is her responsibility to preserve the life and health of her patients. That’s a far cry from the hospital forcing her to assist in a pre-planned, elective abortion where there is all kinds of time to put together a medical team. Likewise, there are many people who, out of religious obligation, leave work before sundown on Friday. I think that’s great and should be accommodated to the best of an employer’s ability. But if I get injured on the job and a co-worker starts to help me and the clock strikes 3, that’s the line where they can’t go, “Oops, Sabbath, gotta go!” and leave me to bleed to death. Leave a project, fine. Leave a co-worker with a paper cut, ok. But the rules are different when you’ve started to help someone who is imminent danger. They are very different when you’ve been hired to help people who are in imminent danger.
Doctors, nurses and pharmacists are also licensed practitioners. They are required to get government approval in order to practice, and the fields additionally self-regulate. When you work in a field like that — and I also work in a regulated field — there are certain standards and practices that you have to maintain. You can’t just go all renegade; there are legal and ethical concerns that have to be taken very seriously. Medicine is regulated because it’s more than a market good; it’s often a life-sustaining necessity.
So no, this is not as simple as “We live in a capitalist society and I can sell what I want.”
Conscience clauses and making space for moral and religious beliefs are good things, but they are not always easy things to construct. This case, if the reporting on it is accurate, may show where those lines grow fuzzy around the edges.
- Pharmacists refusing to fill prescriptions for potentially life-saving drugs by Jill January 13, 2011
- Washington pharmacists angry that they have to do their jobs by Jill July 27, 2007
- #DearJohn: The GOP Seeks to Re-Define Rape and Restrict Reproductive Health Care by Jill January 31, 2011
- Pro-Lifers: Increasing the Abortion Rate in Your State by Jill February 2, 2008
- Moral Refusal Clauses: More Than Just Contraception by Jill June 23, 2008