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Proposed new federal regulation

 
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LLB



Joined: 21 Mar 2007
Posts: 869
Location: Dallas, Texas

PostPosted: Mon Sep 01, 2008 11:14 am    Post subject: Proposed new federal regulation Reply with quote

From a new blog entry I posted this morning:

Quote:
The Bush administration has proposed a new guideline that would provide protection for health-care workers who refuse, on religious or moral objections, to provide certain forms of legal healthcare, and further, that those workers are not required to refer patients to another venue where they might be helped. Nearly 600,000 hospitals and doctor's offices that receive any form of federal funding would need to certify, in writing, that they protect the "conscience" rights of healthcare workers. Those who refuse to comply could lose funding and be sued for previous money received by the federal government.

This guideline is set to go into effect in less than a month's time, and its aim is abortion, but the vagueness of the way the guideline is written leads many to believe that contraceptives are or will be covered. Regardless of your feeling on abortion, please keep in mind that female contraceptives were legalized for all women - not just married ones - in the 1960s. When I googled this guideline, interestingly (at least to me) one of the articles I found was an editorial from a Utah (emphasis added due to Utah's very conservative population and government) newspaper that I'll excerpt here:

Quote:
Instead, a new rule Leavitt is proposing would, in essence, force poor women to limit their health care choices to just those that are morally acceptable to taxpayer-funded providers.
Now that is morally suspect.
The rule would allow anyone who works at a clinic or hospital that receives federal Title X funds to refuse to do their job if it means that, as a result, a woman could get access to a contraceptive or surgical procedure that the worker believes is morally wrong.
...this proposed rule goes far beyond the abortion issue. It could mean a woman who visits a federally funded clinic might not receive information about contraceptive options, including emergency contraceptives that could prevent a rape victim from becoming pregnant. That is medically indefensible.
Some people's religions or personal principles dictate that abortion and surgical sterilization are always wrong, and some belief systems extend that abhorance to contraceptives. But the reality is that contraception, for most people, is a health issue, not a moral issue...
Leavitt, Utah's former governor, says doctors who oppose contraceptives and abortion are victims of discrimination if they are required to simply explain all available options.


I'd like to keep the focus on the birth control aspects, although obviously I have no control over that. But because of this issue's sensitivity, I do plan to keep a close eye on this discussion.
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Jane G



Joined: 29 Jun 2007
Posts: 277
Location: Washington, DC

PostPosted: Mon Sep 01, 2008 1:55 pm    Post subject: Reply with quote

This issue is a hard one for me, because it is something of an intersection of my religious beliefs and my political ones, which are usually fairly different. I do support the right for doctors to refuse to do abortions, or even to skip that class in medical school. And even referring a woman to another doctor who will give them an abortion can be grounds for excommunication from the Catholic Church, and their right to adhere to their religious dictates should be protected.

At the same time, "morally wrong" is a very subjective term. In the case of the Catholic Church and abortion, the rules are stated quite clearly, and it isn't just the opinion of the doctor/pharmacist/nurse. However, there are people who believe organ transplants are "morally wrong"--not many of them, but they exist. Should surgeons be exempt from performing heart transplants for that reason? It's a very gray area, and thus very difficult to legislate.

However-- I do disagree that this should be extended to birth control, or even that the wording should be vague enough that it might be interpreted that way. Birth control (including the morning after pill) are not abortive, and thus they SHOULD be kept separate from laws about abortion. However, politicians tend to stick the two together, and thus the debates become intertwined.
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LindaC



Joined: 26 Mar 2007
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PostPosted: Thu Sep 04, 2008 12:53 pm    Post subject: Federal Regulation Reply with quote

What if the Dr/Pharmacist was a Christian Scientist and insisted that your diabetic child didn't need insulin, only prayer? What if they were Jehovah's Witnesses and allowed your loved one to die rather than call for a transfusion? I know, this would NEVER happen. But to borrow a slogan from the NRA, the government starts little and moves on to the big things later.

If you don't want to provide all the legal health care and legal drugs available to your patients, regardless of your feelings/beliefs, then DO SOMETHING ELSE. What happened to the Hippocratic Oath? First do no harm!

This is just another way for the religious right to impose their beliefs on the rest of us.
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LLB



Joined: 21 Mar 2007
Posts: 869
Location: Dallas, Texas

PostPosted: Thu Sep 04, 2008 1:03 pm    Post subject: Re: Federal Regulation Reply with quote

LindaC wrote:
What if the Dr/Pharmacist was a Christian Scientist and insisted that your diabetic child didn't need insulin, only prayer?


I appreciate the sentiment, but I don't think a Christian Scientist would become a pharmacist to begin with. Wink
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Tee



Joined: 22 Mar 2007
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Location: Detroit Metro

PostPosted: Thu Sep 04, 2008 2:06 pm    Post subject: Re: Federal Regulation Reply with quote

LindaC wrote:
What if the Dr/Pharmacist was a Christian Scientist and insisted that your diabetic child didn't need insulin, only prayer? What if they were Jehovah's Witnesses and allowed your loved one to die rather than call for a transfusion?

Actually, just to answer your question and not necessarily get into the other stuff, Linda, if I felt I needed a certain med and my pharmacist would not fill the prescription, I would go to another pharmacy until I found someone that would fill it.

That would go for a doctor's recommendation also. If someone felt differently than a doctor suggested, we have always had the second and even third opinion philosophy here in the US. I don't believe that's changed much. We are encouraged to at least get a second opinion and you can choose which doctor you go to in most cases.

I realize this probably doesn't cover emergency room cases; but most hospitals have more than one doctor on duty, unless they're very small. That rural hospital could be a problem. I don't know.
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Karen Templeton



Joined: 22 Mar 2007
Posts: 298

PostPosted: Thu Sep 04, 2008 2:23 pm    Post subject: Reply with quote

Quote:
What if the Dr/Pharmacist was a Christian Scientist and insisted that your diabetic child didn't need insulin, only prayer?


As LLB said, a sincere adherent of Christian Science would find any aspect of pharmaceuticals in direct opposition to his/her beliefs. Not to say that a pharmacist couldn't *begin* to study Christian Science while still practicing in the medical field -- there are plenty of former doctors and nurses among the ranks -- but at some point their conscience would probably lead them to give up the profession entirely.

To my mind, if someone decides to pursue a profession, knowing that some aspects of it are going to come into conflict with his/her deeply held beliefs, than perhaps that individual should think long and hard about whether that's the right profession for him/her. I don't suppose it's that much of a problem in a large pharmacy, where another pharmacist can be readily called out to fill the prescription; but in a more limited situation, it doesn't seem right to me. (And to flat out refuse to refer someone to another pharmacist smacks of using one's job to make a political/religious statement.)

It would be like a vegetarian waiter refusing to serve meat in a restaurant that does, rather than finding a job in a vegetarian restaurant -- only with potential far more dire circumstances.

Karen T.


Last edited by Karen Templeton on Thu Sep 04, 2008 2:25 pm; edited 1 time in total
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LLB



Joined: 21 Mar 2007
Posts: 869
Location: Dallas, Texas

PostPosted: Thu Sep 04, 2008 2:29 pm    Post subject: Re: Federal Regulation Reply with quote

Tee wrote:
Actually, just to answer your question and not necessarily get into the other stuff, Linda, if I felt I needed a certain med and my pharmacist would not fill the prescription, I would go to another pharmacy until I found someone that would fill it.

That would go for a doctor's recommendation also. If someone felt differently than a doctor suggested, we have always had the second and even third opinion philosophy here in the US. I don't believe that's changed much. We are encouraged to at least get a second opinion and you can choose which doctor you go to in most cases.

I realize this probably doesn't cover emergency room cases; but most hospitals have more than one doctor on duty, unless they're very small. That rural hospital could be a problem. I don't know.


Tee -

I hear what you're saying, but the way this regulation is crafted, it's possible even birth control may be in jeopardy. The pill, for instance, has been legal for all women - not just married women - for forty some-odd years, and though not everyone may agree, abortion has also been legal for 35 years. Women are not asking doctors or pharmacists to perform an illegal action...they're asking that legal drugs and procedures be made available. To have a pharmacist say, "Sorry...I'm X religion and we don't believe in birth control" would be insulting beyond all belief. If somebody has a problem dispensing legal medications, they ought to find a new job.

As I've posted, my local CVS keeps pregnancy tests under lock and key, and condoms too, and big signs announce the aisle is being filmed. How many girls and/or young women are afraid/embarrassed to have to go to the manager of the store to ask that the cabinet be unlocked, particularly if they are being filmed? That's a very chilling effect, and I think many of us are going to discover some day soon that a lot of things we long considered the status quo are no longer there for us. Be it the ability to obtain legal birth control without having to fight about it or, and this stands in opposition to the Republican platform, that a woman raped or victimized by incest has the right to an abortion.
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Tee



Joined: 22 Mar 2007
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PostPosted: Thu Sep 04, 2008 3:02 pm    Post subject: Re: Federal Regulation Reply with quote

LLB wrote:
If somebody has a problem dispensing legal medications, they ought to find a new job.

Can't disagree at all with what you said here, LLB. Karen Templeton also said something similar: "To my mind, if someone decides to pursue a profession, knowing that some aspects of it are going to come into conflict with his/her deeply held beliefs, than perhaps that individual should think long and hard about whether that's the right profession for him/her."

I'd rather keep talking about medications here, because I'm one of those who have very strong opinions regarding abortion. So in relation to the subject of dispensing meds, if something is the law, then a person has the right of obtaining it. If a pharmacist, because of his beliefs, cannot dispense it, then the company employing him should have a backup plan. This wouldn't be much of a problem in a fairly large city because there would be alternate places to receive them and one would not go back to the original store. But in a small town, this could be a problem.

I am going to have go back to your original post on this and re-read the info you included regarding this proposed legislation. I'm doing some sub-contract work out of my home on my computer and I'm sure I haven't given my full attention to all the info that you attached. I was visiting the AAR site as a break from the reports and immediately responded to the question that Linda posed. Sorry about that.
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Maggie AAR
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Joined: 23 Mar 2007
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PostPosted: Thu Sep 04, 2008 3:46 pm    Post subject: Re: Federal Regulation Reply with quote

LLB wrote:

As I've posted, my local CVS keeps pregnancy tests under lock and key, and condoms too, and big signs announce the aisle is being filmed. How many girls and/or young women are afraid/embarrassed to have to go to the manager of the store to ask that the cabinet be unlocked, particularly if they are being filmed?


I am still working on how to respond to most of this topic but would like to address this one portion quickly.

My first question would be - have you asked them why? I know these two items are often stolen and that is why at some Walgreens (depends on the neighborhood),Targets and Walmarts they are behind the counter and at others they are not. I know that this is true in my town because I *did* ask the manager's at several stores about why they were in dark, corner aisles in some stores and virtually had security guards in front of them in others. It seems reasonable to me that the stores not have to pick up the tab for peoples b/c issues. It seems unfair sometimes that all of us most be punished for the criminal acts of the few but that is not a sexual issue. It's a pretty complex political/moral/criminal one. Since condoms are fairly cheap, I don't think it is an issue of the poor among us not being able to afford them. They tend to be a buck a piece, about the same price as a soda so again I think this is because they *can* be stolen, not because they need to be stolen.

Regarding the embarrassment issue -- there is a bit of a maturity element in all of this for me. Just when is a person ready for sex? Shouldn't it at least involve the maturity to get the supplies they need to do this safely? I mean, teens seem to find cigarettes and alcohol easy enough and yet they can't take care of this? I go back to what I've said before -- our problems are not with education nor with availability. Our problems tend to be in the very confused attitudes of the teens, who probably got that confusion from their own parents. Confused

maggie b.
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LLB



Joined: 21 Mar 2007
Posts: 869
Location: Dallas, Texas

PostPosted: Thu Sep 04, 2008 4:24 pm    Post subject: Re: Federal Regulation Reply with quote

maggie b. wrote:
My first question would be - have you asked them why? I know these two items are often stolen

Regarding the embarrassment issue -- there is a bit of a maturity element in all of this for me. Just when is a person ready for sex? Shouldn't it at least involve the maturity to get the supplies they need to do this safely? I mean, teens seem to find cigarettes and alcohol easy enough and yet they can't take care of this? I go back to what I've said before -- our problems are not with education nor with availability. Our problems tend to be in the very confused attitudes of the teens, who probably got that confusion from their own parents. Confused

maggie b.


Maggie -

These are not the most expensive or small items on sale at the CVS. Certain things are more subject to theft than others, BUT many believe there is a "moral" component to the decision. And, by doing this, they are discouraging the use of condoms. Even at my age I'd be pretty upset to have to ask for somebody to unlock them for me; it's nobody's business, and knowing that I'm being filmed makes the whole Big Brother thing very much front and center.

Remember, pregnancy tests are also under lock and key...and surveillance. Unless I was trying to get pregnant, I would be bothered to have to ask somebody to unlock one for me, particularly if I were being filmed.

Lots of stores lock up razor blades, but they don't have signs proclaiming video surveillance to intimidate people. To me that's the scariest part of this whole thing.
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Margaret



Joined: 23 Mar 2007
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PostPosted: Thu Sep 04, 2008 5:20 pm    Post subject: Re: Federal Regulation Reply with quote

Quote:
Tee wrote...If a pharmacist, because of his beliefs, cannot dispense it, then the company employing him should have a backup plan.


Tee, I think this is an area where we are not of like mind. I strongly disagree with this. People go into a pharmacy to get professional help and get healthy-not to be subjected to someone else's moral judgements or beliefs. There should be some regulation that a pharmacist cannot refuse treatment. A very difficult subject for many reasons.
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Tee



Joined: 22 Mar 2007
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PostPosted: Thu Sep 04, 2008 5:40 pm    Post subject: Re: Federal Regulation Reply with quote

Margaret wrote:
There should be some regulation that a pharmacist cannot refuse treatment. A very difficult subject for many reasons.

I guess that's why I said the company that employs him should have a backup plan because they are the ones that are ultimately responsible for the medication not being dispensed. Again, in a fairly populated area, this is probably no big thing; but it could be in a place where there is only one drug store in the area. And I'm sure there are some of those places around. Heck, in our area, we have drug stores on every corner, it seems, and more being built.

But you're right, Margaret. What seems cut and dried to me isn't necessarily so for others. On the other hand, other issues which appear very black and white in their minds are not that crisp and clear for me.
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Maggie AAR
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Joined: 23 Mar 2007
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PostPosted: Thu Sep 04, 2008 7:23 pm    Post subject: Re: Federal Regulation Reply with quote

LLB wrote:
maggie b. wrote:
My first question would be - have you asked them why? I know these two items are often stolen

Regarding the embarrassment issue -- there is a bit of a maturity element in all of this for me. Just when is a person ready for sex? Shouldn't it at least involve the maturity to get the supplies they need to do this safely? I mean, teens seem to find cigarettes and alcohol easy enough and yet they can't take care of this? I go back to what I've said before -- our problems are not with education nor with availability. Our problems tend to be in the very confused attitudes of the teens, who probably got that confusion from their own parents. Confused

maggie b.


Maggie -

These are not the most expensive or small items on sale at the CVS. Certain things are more subject to theft than others, BUT many believe there is a "moral" component to the decision. And, by doing this, they are discouraging the use of condoms. Even at my age I'd be pretty upset to have to ask for somebody to unlock them for me; it's nobody's business, and knowing that I'm being filmed makes the whole Big Brother thing very much front and center.

Remember, pregnancy tests are also under lock and key...and surveillance. Unless I was trying to get pregnant, I would be bothered to have to ask somebody to unlock one for me, particularly if I were being filmed.

Lots of stores lock up razor blades, but they don't have signs proclaiming video surveillance to intimidate people. To me that's the scariest part of this whole thing.


In regards to this, I can speak only to my own area and experiences. In the area I live and where my family lives (Missouri) the difference is only in whether or not you are in a high crime area. So the Walgreens near me (in Wisconsin) and the one near my mom (in southern MO) has them out in the open and the area where my sister lives (rough neighborhood, about 20 miles away from mom, high crime rate) and where I work (high crime rate) has these things locked up. I think part of it is not just that they are small but they are something that teens want and those things, just like CD's and video games, get stolen more.

Each area might be different though and I guess it's possible that it could be due to some kind of moral component in other areas. I just know about the areas that I am familiar with and there it most definitely is not.

maggie b.
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