AL HB31: Where saving a woman’s life becomes a question of conscience

Conscience laws. Fucking conscience laws.

In this case, the fucking “Health Care Rights of Conscience Act,” Alabama HB31, which would allow the entire hospital staff, including but not limited to physicians, nurses, pharmacists, counselors, and social workers, to refuse to provide medical care in situations that would “violate their conscience.”

Now, this doesn’t apply to every potentially objectionable procedure a hospital might perform — only abortion, human cloning, human embryonic stem cell research, and sterilization. Only things that allow them to pit the life of a fetus against the life of a person.

Section 4. (a) A health care provider has the right not to participate, and no health care provider shall be required to participate, in a health care service that violates his or her conscience when the health care provider has objected in writing prior to being asked to provide such health care services.

(b) No health care provider shall be civilly, criminally, or administratively liable for declining to participate in a health care service that violates his or her conscience except when failure to do so would immediately endanger the life of a patient.

So if a woman comes into the hospital in the throes of a miscarriage and her life isn’t in immediate danger (in which case they would be required to treat her until a non-objecting provider could be found), by law every provider in the ER can refuse to treat her if treatment would result in the termination of the pregnancy.

So if you’re about to die, then yes, they’re required to treat you until another health care provider can be brought in. If it’s merely your health that’s in danger? Your mental health? Your future fertility? If you aren’t dying now from hemorrhaging but will ultimately die later from sepsis because no one was willing to treat you when you first came in? That’s a shame, and (legally) not the hospital’s fault. As with Savita Halappanavar, who died in excruciating pain from septicemia after a hospital — in Ireland, “a Catholic country” — refused to treat her for her miscarriage because the fetus still had a heartbeat. And if that were to happen to a woman in Alabama, there would be no recourse or punishment to the hospital, because conscience.

(e) Except as otherwise provided in this section, a hospital, as defined in Section 22-21-20, Code of Alabama, 1975, or other health care entity, and any employee, physician, member, or person associated with the hospital or other health care entity is immune from liability for any damage caused by the refusal of a health care provider to participate in a health care service defined in this act at a facility owned, operated, or controlled by the hospital or other health care entity.

So ultimately, the penalty for refusing to provide treatment even when no other provider is available is… nothing. The penalty for knowing that none of the physicians on hand would be willing to administer care and not bothering to find anyone who will is nothing. If your conscience is bothered, a woman’s life is worth nothing.

HB31 has passed the House and was expected to go before the state Senate this past week, before winter weather threw the state into a tailspin. If you’re in Alabama, contact your state senator to let them know that saving a woman’s life isn’t a matter of conscience. And if you’re not in Alabama? Primary sponsor Becky Nordren (R-29) and cosponsor April Weaver (R-49) don’t appear to understand the potential impact of this bill on women’s lives. If you do understand, you might shoot them an e-mail to help them out.

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45 Responses

  1. Comrade Kevin
    Comrade Kevin January 31, 2014 at 5:46 pm |

    If I said I was surprised, I would be lying. I know Alabama politics extremely well. If the bill passes the Senate, I wonder if Governor Bentley would sign it. He is a physician, but I think he’s also pro-life.

  2. macavitykitsune
    macavitykitsune January 31, 2014 at 6:05 pm |

    I wish I could make being anti-choice a disqualifying belief for entry into any kind of health or education training program.

    1. Ally S
      Ally S January 31, 2014 at 6:12 pm |

      Not wanting anti-choice assholes to be free to enter health/education training programs? What next, are you going to say that reproductive rights are important? I fear your hostility will only get worse and worse. :(

      1. macavitykitsune
        macavitykitsune January 31, 2014 at 6:13 pm |

        Clearly I’m a toxic brown feminist.

        1. kittehserf
          kittehserf January 31, 2014 at 9:53 pm |

          Could be worse, you could be a soylent green feminist.

    2. ldouglas
      ldouglas January 31, 2014 at 6:13 pm |

      I wish I could make being anti-choice a disqualifying belief for entry into any kind of health or education training program.

      I’d love for people to be asked if they’d have any problem carrying out any part of the duties of the medical profession for which they’d be training, and refused admittance if so. This wouldn’t just include views on abortion, but on treating women, performing sterilizations, etc.

      I agree that the pro-life movement sucks, but I’m not sure I could actually get behind banning people from jobs for their ideological/religious beliefs when those jobs didn’t directly relate to said beliefs (assuming you meant your comment literally, and not just a ‘fuck you’ to pro-lifers, which I would be completely behind).

      1. Ally S
        Ally S January 31, 2014 at 6:22 pm |

        I’m not sure I could actually get behind banning people from jobs for their ideological/religious beliefs when those jobs didn’t directly relate to said beliefs

        I see what you mean, but it’s hard to imagine someone’s anti-reproductive-rights stance not also influencing their actions. Even if their beliefs don’t motivate them to deny patients certain treatments, they are still likely to be detrimental in other ways. For example, a pro-lifer could pressure and shame the patient into not getting an abortion, contraception, and so on.

        1. ldouglas
          ldouglas January 31, 2014 at 7:06 pm |

          I see what you mean, but it’s hard to imagine someone’s anti-reproductive-rights stance not also influencing their actions.

          Sure, but you can insert a lot of things for ‘anti-reproductive-rights’ in that sentence and it still works.

          I wouldn’t want to live in a country where the government banned people of certain ideological views from jobs that didn’t directly relate to said views, even the views I find repugnant. There’s very little guarantee the views it picked would be the same ones I dislike, for one thing.

          I’m not sure macavity meant her post as a policy proposal, and not just a cathartic ‘anti-choicers suck.’ So I don’t want to write this as if it’s a rebuttal to her. But if you and I are talking about actual policy here, the implications of trying to identify people’s political/religious/ideological leanings alone are deeply problematic.

        2. macavitykitsune
          macavitykitsune January 31, 2014 at 7:20 pm |

          banned people of certain ideological views from jobs that didn’t directly relate to said views,

          In what world does “anti-choice” not directly relate to “medical professions”!?!?!?!!?!?!?!?!?! Like, you’ve said this about four times now and I genuinely do not understand the level of cognitive dissonance required to disconnect reproductive choice and reproductive medicine. (Obvs if an anti-choicer wants to be a dentist or an optician or a pathologist or a mortician I don’t care, but a nurse/GP/ob-gyn/pharmacist is probably going to be responsible for the health of a pregnant person at some point, and a teacher will probably have to give kids counseling about sex ed/health at some point.)

          And honestly, it was part cathartic, part policy. I would bar people in any (hate group) from (job that directly affects the lives of hated group). I.E. People in Stormfront don’t get jobs with black youth, Nazis don’t get to be security guards at synagogues and anti-choicers don’t get jobs making medical decisions for pregnant people.

        3. ldouglas
          ldouglas January 31, 2014 at 7:29 pm |

          In what world does “anti-choice” not directly relate to “medical professions”!?!?!?!!?!?!?!?!?!

          Like, you’ve said this about four times now and I genuinely do not understand the level of cognitive dissonance required to disconnect reproductive choice and reproductive medicine.

          I can’t tell if you’re being deliberately disingenuous, but what you just did was substitute ‘reproductive medicine’ for ‘medical professions,’ which sure looks like it.

          I don’t know how to say this without sounding condescending, but not all medical professions involve reproductive medicine. For example, some people are dentists.

        4. ldouglas
          ldouglas January 31, 2014 at 7:31 pm |

          Argh, messed up the blockquoting.

          In any case, I have no idea how to wrap my head around your objection. I said “keep anti-choicers out of medical fields that relate to reproductive health;’ you responded ‘I genuinely do not understand the level of cognitive dissonance required to disconnect reproductive choice and reproductive medicine. ‘

          …bwuh?

        5. macavitykitsune
          macavitykitsune January 31, 2014 at 7:44 pm |

          I don’t know how to say this without sounding condescending, but not all medical professions involve reproductive medicine. For example, some people are dentists.

          Well, as it turned out you’re sounding like an ass, because in the comment you’re responding to, I specifically clarified to say the following:

          (Obvs if an anti-choicer wants to be a dentist or an optician or a pathologist or a mortician I don’t care,

          So… what is your actual disagreement?!? You raised an objection, I clarified, and then you…repeated my point? Well done?

        6. ldouglas
          ldouglas January 31, 2014 at 8:07 pm |

          So… what is your actual disagreement?!? You raised an objection, I clarified, and then you…repeated my point? Well done?

          1) I said “I’d like to keep pro-life folks out of jobs that relate to reproductive health.”
          2) You responded with a series of non-sequitors like “I genuinely do not understand the level of cognitive dissonance required to disconnect reproductive choice and reproductive medicine.”
          3) …?

          Like, I don’t get why you think we disagree over something.

        7. macavitykitsune
          macavitykitsune January 31, 2014 at 8:43 pm |

          ldouglas, I’m pretty confused too because I feel like we’re talking over each other and I’m missing your pov. I’m in agreement with your current position…

          Argh. I’m sorry. I’m having a weird day and I can’t communicate. D:

        8. ldouglas
          ldouglas February 1, 2014 at 10:34 pm |

          Argh. I’m sorry. I’m having a weird day and I can’t communicate. D:

          Or I was. Ha, sorry this turned into an argument over, uh, how much we agreed?

      2. macavitykitsune
        macavitykitsune January 31, 2014 at 6:29 pm |

        I’d love for people to be asked if they’d have any problem carrying out any part of the duties of the medical profession for which they’d be training, and refused admittance if so. This wouldn’t just include views on abortion, but on treating women, performing sterilizations, etc.

        Agreed. This would work, if anti-choicers could be relied upon not to lie. Unfortunately, given their track record, I don’t trust an anti-choicer as far as I could throw them, and with my disabilities I doubt I could even lift ‘em.

        I’m not sure I could actually get behind banning people from jobs for their ideological/religious beliefs when those jobs didn’t directly relate to said beliefs

        I’m not saying I want anti-choicers to be banned from driving school buses or serving burgers or writing poetry. I just don’t ever want them making medical decisions for me or anyone else, certainly any other uterusy person, or being in charge of what my kid learns about sex and reproduction. Do you honestly think that someone whose beliefs are “I literally value your health and life less than that of a clump of cells in your body, Because Jebus” should just be allowed to waltz into a position where they can (and they do, btw) literally kill people for having the misfortune to be pregnant? I mean, if you do, cool, but you’re braver than I am!

      3. ldouglas
        ldouglas January 31, 2014 at 7:11 pm |

        Agreed. This would work, if anti-choicers could be relied upon not to lie. Unfortunately, given their track record, I don’t trust an anti-choicer as far as I could throw them, and with my disabilities I doubt I could even lift ‘em.

        Well, no, except that it would prevent this whole ‘conscience’ issue from even arising.

        Do you honestly think that someone whose beliefs are “I literally value your health and life less than that of a clump of cells in your body, Because Jebus” should just be allowed to waltz into a position where they can (and they do, btw) literally kill people for having the misfortune to be
        pregnant?

        No, which is why I said:

        I’d love for people to be asked if they’d have any problem carrying out any part of the duties of the medical profession for which they’d be training, and refused admittance if so. This wouldn’t just include views on abortion, but on treating women, performing sterilizations, etc.

        1. macavitykitsune
          macavitykitsune January 31, 2014 at 7:21 pm |

          You have the notion that anti-choicers wouldn’t lie about being anti-choice in order to get into positions of power over pregnant people. This is my fundamental issue with your statements; other than that we’re solidly in agreement.

        2. ldouglas
          ldouglas January 31, 2014 at 7:27 pm |

          You have the notion that anti-choicers wouldn’t lie about being anti-choice in order to get into positions of power over pregnant people.

          I do not, and I have no idea why you think I do, considering I said that the only reason such a policy might be valuable is:

          it would prevent this whole ‘conscience’ issue from even arising

          because everyone working in said fields would have already attested to the fact that they didn’t have a problem of conscience, and lying on a job application is a fireable offence.

        3. ldouglas
          ldouglas January 31, 2014 at 7:34 pm |

          And that objection seems even stranger considering you basically proposed a similar policy which would have the exact same (in your view) defect.

        4. macavitykitsune
          macavitykitsune January 31, 2014 at 7:45 pm |

          because everyone working in said fields would have already attested to the fact that they didn’t have a problem of conscience, and lying on a job application is a fireable offence.

          It’d be really easy to claim that they changed their mind after the point at which they signed the thing. You’re right, though; that is a fireable offense. I hadn’t considered that aspect of it at all.

    3. kittehserf
      kittehserf January 31, 2014 at 9:52 pm |

      Damn right, mac. Sometimes I wonder why these “let the incubator females die” types get into so-called healthcare at all.

      1. kittehserf
        kittehserf January 31, 2014 at 9:57 pm |

        *or incubator uterus-havers, I should have said, not that I’d expect an anti-choicer to acknowledge they were dealing with a pregnant trans man.

  3. ldouglas
    ldouglas January 31, 2014 at 6:06 pm |

    Now, this doesn’t apply to every potentially objectionable procedure a hospital might perform — only abortion, human cloning, human embryonic stem cell research, and sterilization. Only things that allow them to pit the life of a fetus against the life of a person.

    I’m not quite sure what sterilization has to do with a fetal life.

    More broadly, I hope that the fact people must specific what procedures they’ll refuse to perform in advance means that hospitals will be able to assign people who didn’t submit letters to those patients; obviously this is contingent on not everyone submitting said declaration.

    Overall, though, ugh.

    1. macavitykitsune
      macavitykitsune January 31, 2014 at 6:32 pm |

      Yes, well, if women* could get sterilised when they want, it’d be harder to keep them properly barefoot and pregnant. So much of the reproductive coercion structure is dependent on women* constantly being terrified of pregnancy that of course sterilisation is a feminist issue. From a more personal, bitter POV, I’m just fucking raging that I can’t get my tubes tied until I’m significantly older, even though I’m very clear I don’t want to bear a child, ever.

      1. ldouglas
        ldouglas January 31, 2014 at 7:21 pm |

        I’d be shocked if you could find anyone here who thought sterilization wasn’t a feminist issue! But of course, “feminist issues” and “things that allow them to pit the life of a fetus against the life of a person” aren’t the same.

        By the way, is the asterisk after ‘women’ to denote ‘people with female reproductive organs,’ so as not to exclude trans men with uteri?

        1. macavitykitsune
          macavitykitsune January 31, 2014 at 7:46 pm |

          Yes, it is. Obviously you and I know that “people with uteri” isn’t a perfect overlap with “woman” by a long shot, but The Patriarchy(TM) doesn’t recognise that.

        2. kittehserf
          kittehserf January 31, 2014 at 9:59 pm |

          But of course, “feminist issues” and “things that allow them to pit the life of a fetus against the life of a person” aren’t the same.

          I’m not sure I’m following your line of thought, but I’d say pitting the life of a fetus against the life of the person carrying it is very much a feminist issue. (This was your Captain Obvious announcement of the day.)

        3. Victoria
          Victoria February 1, 2014 at 1:29 am |

          @kittehserf

          I think it’s a category thing. Not every feminist issue is a thing that allows people to pit the life of a fetus against the life of a person, but things that allow people to pit the life of a fetus against the life of a person are always feminist issues. Sterilization is a feminist issue, but there isn’t a fetus involved (because it would be dangerous if there was).

        4. ldouglas
          ldouglas February 1, 2014 at 10:32 pm |

          What Victoria said.

      2. TomSims
        TomSims February 1, 2014 at 11:54 am |

        @macavity

        I agree completely. As long as you are of the legal majority age (18 in most states), it should be your choice and your’s alone. Until I read your post, I had no idea you were not able to get your tubes tied when you wanted to.

        1. Andie
          Andie February 1, 2014 at 9:38 pm |

          In some places, it’s near impossible to get a tubal before age 25. Even if you already have kids, doctors balk at sterilization before 25. I only got mine without trouble because pregnancy was potentially lethal with my health problems (apparently kid number two was a much higher risk pregnancy than I was aware) and I couldn’t take any hormone based contraceptives.

          Keeping in mind, I’m also a white, low-middle class woman, so I know that mine and the experiences of some of my friends who have tried to be sterilized are not universal by any means, and it’s actually really fucked up to consider that for every woman who is actively seeking sterilization and being told she can’t, another woman is tricked or coerced into being sterilized against her will because race, class, disability. That’s fucking depressing.

      3. Victoria
        Victoria February 1, 2014 at 5:46 pm |

        Yes, well, if women* could get sterilised when they want, it’d be harder to keep them properly barefoot and pregnant. So much of the reproductive coercion structure is dependent on women* constantly being terrified of pregnancy that of course sterilisation is a feminist issue.

        Well said. Putting abortion aside for a moment, the fact that we live in a society in which having a child is often financially debilitating, and the fact that those on the right are going after measures that prevent pregnancy before it happened suggests that they are trying to make pregnancy essentially compulsory. If they were really concerned about preventing abortions, they wouldn’t stand in the way of birth control or sterilization.

  4. trees
    trees January 31, 2014 at 6:45 pm |

    How long before they allow health care providers to refuse care to certain classes of persons on grounds of conscience?

    1. Donna L
      Donna L January 31, 2014 at 8:16 pm |

      I think some of the conscience laws are already broad enough to cover that (at least in theory), and to allow people to get away with saying that their religion and/or conscience doesn’t permit them to — for example — provide medical care to trans people.

      1. trees
        trees January 31, 2014 at 8:47 pm |

        It sounds like that would be in direct violation of professional codes of conduct, and could maybe put providers licenses to practice in jeopardy.

        1. macavitykitsune
          macavitykitsune January 31, 2014 at 10:05 pm |

          It would seem so, but you know, I’d bet that gets ignored and the people given a pass in the same way people claiming “trans panic” get given a pass even though it’s morally a complete farce. (I mean… when was the last time a woman got away with killing a man just because he casually hit on her? Ohrightnever.)

        2. trees
          trees January 31, 2014 at 10:31 pm |

          I’m sure in practice that’s absolutely the case, but making a successfully argument for conscientious objection before a professional licensure board seems less likely.

    2. Victoria
      Victoria February 1, 2014 at 6:10 pm |

      Along similar lines, what is to keep a medical provider from deciding that they object to treating someone who has had an abortion (for something unrelated to an abortion) on moral grounds? Sometimes the question comes up in medical questionnaires, depending on the symptoms a person is presenting. What is to stop someone from saying “I’m opposed to abortion/sterilization/etc. and I believe helping someone who has had this procedure is an endorsement of this behavior goes against my morals.”

      I recently had a hysterectomy. I’m 25, unmarried, and I have no children. I have had multiple people tell me that they believe the surgery was morally wrong from their religious perspective because I should have waited until I was married with children or spent at least a decade trying. These people aren’t medical professionals, but if they were, I’m sure they would have made my life difficult, especially with the sheer vitriol they directed at me.

  5. BroadBlogs
    BroadBlogs January 31, 2014 at 10:19 pm |

    If you can’t do your job, get a different job.

    1. H-naught
      H-naught February 1, 2014 at 2:23 am |

      Yes! While of course there should always be reasonable* workplace accommodations for religious/moral beliefs people shouldn’t be able to use those beliefs to neglect their job duties. It would be like if a defense lawyer thought all people accused of drug related crimes should go to jail but would still take clients accused of such crimes but then not actually defend the client. It’s immoral, and if you think part of your career (and in this case it is a career that people would have spent many years training to do) is so immoral that you won’t do it, you shouldn’t be in that career.

      *I do see that reasonable accommodation varies with job type and setting, e.g. a hospital or factory could have a stricter dress code for health and safety reasons than an office

  6. lhmezzo
    lhmezzo February 3, 2014 at 3:07 pm |

    I’m wondering if people on this blog know of CARASA, Committee for Abortion Rights and Against Sterilization Abuse, which was the first reproductive rights organization I worked with in the mid-late 1970s in NYC. As far as I know, we were the only group at the time linking these issues. We spent a lot of energy fighting the Hyde Amendment, which is currently before Congress for permanent enshrinement. I know much activism is rightly being directed at the avalanche of (unconstitutional) state-level restrictions and prohibitions, but we need to maintain this fight on the federal level as well, especially during the parsing of the ACA.

    1. Sharon M
      Sharon M February 4, 2014 at 10:11 pm |

      6.lhmezzo
      February 3, 2014 at 3:07 pm | Permalink | Reply

      I’m wondering if people on this blog know of CARASA, Committee for Abortion Rights and Against Sterilization Abuse, which was the first reproductive rights organization I worked with in the mid-late 1970s in NYC. As far as I know, we were the only group at the time linking these issues. We spent a lot of energy fighting the Hyde Amendment, which is currently before Congress for permanent enshrinement. I know much activism is rightly being directed at the avalanche of (unconstitutional) state-level restrictions and prohibitions, but we need to maintain this fight on the federal level as well, especially during the parsing of the ACA

      I haven’t heard of that group, thank you. You may be interested in this link:
      http://advocatesforpregnantwomen.org/

      I recommend it for every woman regardless of if you have kids or not.

  7. Elena
    Elena February 22, 2014 at 5:28 am |

    What next, they introduce a new Hippocratic oath – the hypocrite version?

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