In a classic Grimm brothers' fairy tale, the fisherman's wife uses wishes given to her to gain more riches and greater power, until finally she wishes to be the ruler of the universe. The fable teaches the consequences of greed, pride, and it is the ultimate "be careful what you wish for" allegory.
Reproductive health care advocates and providers have written extensively the last few weeks about proposed HHS "conscience protection" regulations -- the period for public comment ends this Thursday, September 25.
In Wisconsin, approximately one-third of all health care organizations are religiously affiliated and many workers sign a contract promising to follow the United States Conference of Catholic Bishops Ethical and Religious Directives for Health Care Services. A July letter from the bishops to members of Congress eagerly embraced the regulations. But the bishops may have neglected the fact that many workers in Catholic hospitals and clinics have moral convictions supporting contraceptive care and reproductive rights and other health care that the church does not sanction or permit.
If the regulations are adopted, family planning service providers, like us, could be forced to hire people who have moral objections to contraception. We would be unable to discipline employees who refuse to provide birth control or other services to our patients, central to our mission. Employees of sectarian health care institutions would operate under the same protections.
For example, clinic employees might refuse to distribute abstinence-only materials because they are incomplete, inaccurate, and deny a patient's right to informed consent. They might have a moral conviction to explain that condoms, correctly and consistently used, are a reliable means to prevent unintended pregnancies, and sexually transmitted infections -- including HIV transmission to fetuses.
Catholic hospital employees might feel, as a matter of conscience, that to deny information about emergency contraception to a victim of rape is morally wrong or that providing pregnancy options information to a high-risk patient without discussion of termination as well as adoption is willful neglect.
Many health professionals in sectarian medical teaching institutions believe that physicians must be trained in modern contraceptive methods, sterilization procedures, and how to perform emergency abortions.
Earlier this year, a Colorado bill, parallel to these regulations, would have prohibited religion-based hiring discrimination. It was loudly criticized by Denver Archbishop Chaput, who said the law would "...greatly hinder organizations like Catholic Charities from maintaining their mission and purpose as specifically religious institutions."
The federal regulations proposed by Secretary Leavitt and supported by the US Conference of Bishops incorporate moral conviction as well as religious belief and extend to all health care providers receiving federal funds. Speaking from the point-of-view of health care providers who understand unintended consequences, here's a thought for the bishops and the Bush administration: "Asking for federal protection for employees who refuse to put patient welfare above personal belief may be equivalent to the fisherman's wife wishing to be the ruler of universe. By asking to rule everything, they ended up with nothing and there the fairy tale ends."
