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Author Topic: Can someone in Michigan tell me if this article is accurate?
Storm Saxon
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http://www.365gay.com/newscon04/04/042204MichMed.htm

quote:

Doctors or other health care providers could not be disciplined or sued if they refuse to treat gay patients under legislation passed Wednesday by the Michigan House.

The bill allows health care workers to refuse service to anyone on moral, ethical or religious grounds.


Does this bill really give all people in the medical field carte blanche to refuse service to anyone?
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Jim-Me
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I think the bill is designed to allow doctors to refuse to perform abortions and can (and should, IMO) probably be amended to not allow this particular variation.

Then again, if you are gay, you probably don't want to be with a doctor that would refuse to treat a homosexual on "moral grounds".

"making those damned sinners get what they deserve" has never been a very Christian position, to say the least.

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Storm Saxon
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I'm pretty sure the hypocratic oath doesn't allow you to not treat someone because they are gay, but you never can tell what some people will get in their head.

I agree with you that the bill sounds too general to really be true. That's why I was asking for clarification.

I can understand the point about not having to perform abortions, but I would think that that one would be pretty easy to resolve in most facilities ahead of time. 'Check here if you will do an abortion.'

Now that I think about it, if it's just for abortions, why the need for the bill? I think I've heard of a couple cases where doctors where pressured to do an abortion, but maybe I'm just ignorant, is the problem that pervasive that it requires legislation?

The whole bill as it's potrayed in the article seems rather odd to me and has the possibility of huge repercussions if it's true.

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kwsni
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As Michigan resident, I feel I have to speak up.

And I have no idea.

Ni!

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Chris Bridges
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I have absolutely no respect for any health care professional that would refuse to treat a person under any circumstances. Refusing to perform surgery you morally disagree with is one thing, refusing to treat a person because you don't like something about them is reprehensible.
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John L
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Do I even need to say it?
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PSI Teleport
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I guess you do.

edit: Honestly, if I were gay I would be glad to have the people who didn't want to treat me allowed to refuse service. Why would you want to be treated by someone who hates you and really doesn't want to? That doesn't seem safe. If someone's really that terrible that they would refuse service because of my (or anyone's) lifestyle, then I wouldn't want them coming near me with a ten-foot-pole.

TWO ten-foot-poles even.

[ April 24, 2004, 08:35 PM: Message edited by: PSI Teleport ]

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Chris Bridges
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Let me amend my statement. In my opinion, anyone desiring to be a health care professional should be someone that would do their very best to help anyone without thinking about who they were. Even suggesting that they should be able to refuse service to an entire class of people on moral grounds disqualifies them in my eyes.

Yes, they're human. I can see someone refusing to operate on a loved one, or even a mortal enemy, for fear of losing the necessary objectivity.

Should white doctors be allowed to turn away black patients, or vice versa? Should we let wounded criminals die? What if the doctor feels that smokers deserve what they get?

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John L
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quote:
edit: Honestly, if I were gay I would be glad to have the people who didn't want to treat me allowed to refuse service.
Uh huh. As the precedent to not treat gays as human beings spreads, it becomes increasingly more difficult to get healthcare. Guess if we can't use religious morality, we'll just let them get sick and die off, right?

Slippery slope? Not if this isn't viewed unconstitutional (on the state and federal level).

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Dagonee
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First, I think it's pretty clear it's aimed at moral objections to the medical procedures, not patients. Abortion, in vitro procedures, even sex change operations. I'm assuming this is to protect from job loss or suit from refusal to do something morally objectionable.

Assuming my assumption is correct, I think the sponsors of the bill need to address this concern quickly and add explicit language banning refusal of treatment based on sexual orientation, or any other attribute of the patient as opposed to the procedure.

Second, even if the interpretation in the article is correct, the only constitutional issue here would involve health care providers at public facilities. There is no constitutional protection from private action.

Dagonee

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John L
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quote:
Second, even if the interpretation in the article is correct, the only constitutional issue here would involve health care providers at public facilities. There is no constitutional protection from private action.
No, but there are federal regulations for medical insurance agencies.
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Dagonee
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True. And a law that said, "Doctors can refuse to operate on homosexuals" while not granting them the right to refuse others would probably be unconstitutional as well (witness the Colorado amendment banning protective laws for homosexuals).

All in all, if it's intended to allow refusal to treat homosexuals it's unconscionable. Given I support the abortion-related aspects, I think it's up to pro-life advocates to reject this interpretation of the bill strongly.

Dagonee

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Storm Saxon
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Just so you know, there is another part of the bill that I consider more dangerous. It allows insurers to not insure those that go against their ethics, as well.

Basically, even just looking at the abortion aspects of the bill, Michigan is looking to run abortion out of the state. Pro life groups will boycott/pressure insurance companies to drop specific clinics, or to not insure them at all. These clinics will then, of course, not be able to operate without insurance liability, forcing them to not offer abortions.

There is a petty part of me that is almost hoping that the language stays in the bill as it is indicated it is written at 365days.com. At least then, there will be a level playing field and other groups can screw with the various 'conservative' groups, too, in the continuing culture war.

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Dagonee
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I have a hard time telling anyone that to be in a particular business they have to support what they consider murder. I thought freedom of conscience was a good thing in America.

Dagonee

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John L
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I didn't know that the freedom to dictate to others what their consciences should be was taking hold in America.

But what the hell, right? It's for their own good.

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Chris Bridges
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I'd like to separate the issues, here. I have no problem with a doctor refusing to perform an abortion because they disagree with the procedure. I have big problems with a doctor refusing to offer the same health procedures they would offer anyone else simply because they didn't like the patient's lifestyle.

[ April 24, 2004, 10:42 PM: Message edited by: Chris Bridges ]

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John L
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How many doctors who are morally opposed to abortion are going to work in an office that conducts abortions?
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Chris Bridges
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Abortions are performed in hospitals on occasion, generally as an emergency procedure.
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Dagonee
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quote:
I didn't know that the freedom to dictate to others what their consciences should be was taking hold in America.

But what the hell, right? It's for their own good.

Right. Which is why people shouldn't be fired or subject to suit for refusing to do something against their conscience (and, in fact, is the equivalent to MURDER in their ethical scheme).

And Chris, that's exactly the right way to split the issues.

Dagonee

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BookWyrm
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This might be the fallout from a pharmacists refusal to fill a 'morning after' script on moral grounds. I 'think' it was an Ekards pharmacist. I'd have to check but I think he may have lost his job over that moral stance.

[ April 24, 2004, 10:48 PM: Message edited by: BookWyrm ]

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John L
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Uh uh. That's not good enough. You can go work at another hospital. A licensed doctor is not bloody likely to not be able to find a job. However, refusing healthcare because you don't like someone's lifestyle is directly threatening a person's health.

If I have to decide between a doctor having a crisis of conscience and someone who needs treatment getting it, the doctor can walk.

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Dagonee
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Oh, so you do want to "dictate to others what their consciences should be."

The bill mandates care in emergency situations.

Dagonee

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John L
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No, they have the right of choice to not place themselves in the position of moral crisis. However, they do not have the right to choose for others what medical care they are eligible for.That is dictating morality.
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Chris Bridges
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John, which are you arguing against? Refusal to perform an abortion or refusal to treat gays? Or both? I'm getting the conversations confused.

[ April 24, 2004, 11:03 PM: Message edited by: Chris Bridges ]

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John L
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A doctor can already refuse to perform an abortion. I'm talking about this legislation about banning treatment to gays.
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Chris Bridges
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Just making sure, since from the outside it seemed like you and Dagonee were in agreement but were arguing anyway.
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Dagonee
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Well, I've clearly opposed the interpretation that allows refusal based on lifestyle in several posts in this thread.

Dagonee

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Storm Saxon
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So, people believe in freedom of conscience, that no one should be forced to do or not do something which they are against. Is this in general or just in the specific instance of abortions?

Let's explore this.

Let's say that I as a business owner employ someone and they want me to give them a certain religious holiday off. I need them to work that day. I think their religion is a bunch of bunk and will probably land them in hell. So, I refuse them that day off both for practical reasons and for principle. Should I as a business owner be forced to give that person a day off, even though it goes against my beliefs? For the purposes of this discussion, let's say that it's impossible for the person who works for me to get another job.

What about a person who doesn't want to give service to employ gay people, or treat gay people, because of their principles. If the principle is important enough, isn't it o.k. to be allowed to not treat gay with gay people. After all, as Theca says, people don't have to give their service to gay doctors. (Yes, Theca. I know you don't support the bill. [Smile] )

Now, let's talk about economic pressure. That is, non-governmental pressure on people or businesses to do things. What if a group doesn't want to do business with an entity that employs gay people in order to pressure them into not employing gay people? Is this o.k.? What about boycotting to keep Christians out? How does it relate to boycotting insurance companies that insure abortion clinics?

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John L
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That's fine, Dag. I wasn't arguing against you personally. I was arguing about what I stated I was arguing about.
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sndrake
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I found a more mainstream and comprehensive article about the bill in the Detroit News:

Gays, Lesbians concerned about Michigan bill

I'm a little familiar with these "conscience clauses" and the aim really isn't to enable health care workers to deny treatment to people with lifestyles they find objectionable.

The reason the gay/lesbian community is tweaking on this is partially a valid concern (I'll explain) over a peculiar legal loophole in the bill and no doubt to give help to "pro-choice" groups that oppose the bill.

Here's the section of the article that highlights the concern for gays and lesbians:

quote:
The bills don’t allow health care providers to object to treating anyone covered by the state’s Elliot-Larsen civil rights act, which bans discrimination based on religion, race, color, national origin, age, sex, height, weight, familial status or marital status.

Kolb, an Ann Arbor Democrat, points out that sexual preference is not on that list.

“If they wanted to cover sexual orientation, they would have to add it in there, and they obviously have not done so,” he said Friday. “It’s blatantly discriminatory at the very least.”

Just in case you missed it, the "problem" is based in the absence of sexual orientation in the state's anti-discrimination act. It's kind of a win-win strategy for gay advocacy organizations - they get to highlight the omission in civil rights legislation and build currency with organizations fighting this bill, which really is aimed at the right to refuse to engage in certain practices and procedures - it's not aimed at letting physicians turn away patients except for the usual reasons - such as being uninsured and unable to pay for services.

Abortion is the most obvious example, but the Detroit News article gives some other examples and talks about the emergence of new ones as medical technology advances.

I'll give one not discussed in the article - what about nurses ordered to facilitate the starvation of an infant with a disability? Shouldn't a medical professional who thinks of this as murder have a right to refuse to participate and still keep his or her job? That example isn't hypothetical, either.

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Dagonee
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quote:
Let's say that I as a business owner employ someone and they want me to give them a certain religious holiday off. I need them to work that day. I think their religion is a bunch of bunk and will probably land them in hell. So, I refuse them that day off both for practical reasons and for principle. Should I as a business owner be forced to give that person a day off, even though it goes against my beliefs? For the purposes of this discussion, let's say that it's impossible for the person who works for me to get another job.
Businesses above a certain size have to make reasonable accommodations. Considering that your refusing to give them the day off won’t keep them out of hell, how does it go against your beliefs to give them the day off? Even if you force the issue with the artificial limitation of no other job, there’s a difference between being actively forced to participate in a morally unsound act and not actively seeking to prevent someone from obeying their own conscience. Go back and read your thread on sexual diversity to get a clear understanding of the distinction.

quote:
What about a person who doesn't want to give service to employ gay people, or treat gay people, because of their principles. If the principle is important enough, isn't it o.k. to be allowed to not treat gay with gay people. After all, as Theca says, people don't have to give their service to gay doctors. (Yes, Theca. I know you don't support the bill. )
Here’s the difference: Someone who doesn’t believe in treating gay people is willing to let them die because of their lifestyle. We have no problem preventing that person from being allowed to kill gay people because they disapprove of their lifestyle. Someone who doesn’t believe in abortion is unwilling to take a life.

quote:
Now, let's talk about economic pressure. That is, non-governmental pressure on people or businesses to do things. What if a group doesn't want to do business with an entity that employs gay people in order to pressure them into not employing gay people? Is this o.k.? What about boycotting to keep Christians out?
What do you mean by OK? Should it be legal? Yes. Should it be done? No. It’s an attempt to deny people access to health care based on prejudice. It’s also why government protections are a good thing – people won’t organize a boycott if they can’t get what they want.

quote:
How does it relate to boycotting insurance companies that insure abortion clinics?
The people who believe that abortion is wrong mostly believe that it is murder. Refusing to do business with people that enable murder seems like a pretty clear moral choice.

Dagonee

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Storm Saxon
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quote:

quote:Let's say that I as a business owner employ someone and they want me to give them a certain religious holiday off. I need them to work that day. I think their religion is a bunch of bunk and will probably land them in hell. So, I refuse them that day off both for practical reasons and for principle. Should I as a business owner be forced to give that person a day off, even though it goes against my beliefs? For the purposes of this discussion, let's say that it's impossible for the person who works for me to get another job.

Businesses above a certain size have to make reasonable accommodations.

They do? Why businesses but not individuals? What's reasonable?
quote:

Considering that your refusing to give them the day off won’t keep them out of hell, how does it go against your beliefs to give them the day off?

I don't believe in their religion. I believe it is either untrue or bad.

quote:

Even if you force the issue with the artificial limitation of no other job, there’s a difference between being actively forced to participate in a morally unsound act and not actively seeking to prevent someone from obeying their own conscience. Go back and read your thread on sexual diversity to get a clear understanding of the distinction.

The principle I am discussing is not doing something because it doesn't mesh with your belief system. Maybe the business owner thinks these people are going to be going to hell. Maybe he has a problem with the holiday. For whatever reason, he find that person morally in the wrong and doesn't want to enable them in their ethical choice.

You say there is 'a difference between being actively forced to participate in a morally unsound act and not actively seeking to prevent someone from obeying their own conscience.' The thing is, Dagonee, is that people who are seeking abortions are obeying their conscience. If we assume there is no other doctor close by (for the sake of argument),the doctor or nurse or whatever holds the same kind of power over the person seeking the abortion that the boss does over the person seeking the day off. That is, they can enable that person's particular ethical choice being carried out.

I'm really just looking at the issue. Remember, it's me you're talking to and not certain other people. [Razz]

quote:


quote:What about a person who doesn't want to give service to employ gay people, or treat gay people, because of their principles. If the principle is important enough, isn't it o.k. to be allowed to not treat gay with gay people. After all, as Theca says, people don't have to give their service to gay doctors. (Yes, Theca. I know you don't support the bill. )

Here’s the difference: Someone who doesn’t believe in treating gay people is willing to let them die because of their lifestyle. We have no problem preventing that person from being allowed to kill gay people because they disapprove of their lifestyle. Someone who doesn’t believe in abortion is unwilling to take a life.

Let's say that just like most abortion cases, the gay person isn't going to die.

By the way, I don't believe the bill gives doctors the ability to say no if the abortion is life saving?
quote:

quote:Now, let's talk about economic pressure. That is, non-governmental pressure on people or businesses to do things. What if a group doesn't want to do business with an entity that employs gay people in order to pressure them into not employing gay people? Is this o.k.? What about boycotting to keep Christians out?

What do you mean by OK? Should it be legal? Yes. Should it be done? No. It’s an attempt to deny people access to health care based on prejudice. It’s also why government protections are a good thing – people won’t organize a boycott if they can’t get what they want.

I didn't even say anything about healthcare this time. [Smile]

Basically, is it safe to say that you believe that freedom of conscience really isn't an issue except in the cases where we are talking about 'life'? And that outside of these cases, a person doesn't have the right to refuse to treat or do business with someone, even if they believe that their 'lifestyle' is morally wrong?

...

quote:

Dagonee

Just out of curiosity, why do you sign your posts? I can see right on the side who it's from. [Confused]
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Dagonee
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quote:
They do? Why businesses but not individuals? What's reasonable?
In short, because it’s the law. The socio-political theory behind requiring businesses to make accommodations is that they have in some sense created a public accommodation (not really the right word, but close enough). In other words, by deciding to participate in the public economic flow, they have purposely availed themselves of the privilege to do business and to receive the benefits and protections of the state-supported economic infrastructure. As part of these benefits and protections, a right to work, ill-defined and not absolute, has been created.

Of course, businesses right now can, in many states, technically discriminate against homosexuals. Some of these states without explicit protection have interpreted certain laws against arbitrary firing to extend some protection to homosexuals. Hopefully explicit protection will be enacted.

My natural inclination is to live and let live. The government intrusion to the extent necessary to enforce anti-discrimination laws carries a default label of “BAD” in my political soul. However, in this case, the effects of letting it go on are worse.

quote:
I don't believe in their religion. I believe it is either untrue or bad.
Understood.

quote:
The principle I am discussing is not doing something because it doesn't mesh with your belief system. Maybe the business owner thinks these people are going to be going to hell. Maybe he has a problem with the holiday. For whatever reason, he find that person morally in the wrong and doesn't want to enable them in their ethical choice.
This is enabling only if we decide that employers should have the right to control aspects of their employee’s lives outside the job. As a society we have decided to not allow employers this control. Therefore, the employer is not enabling any more than he is by not throwing stones at the practitioners of this hypothetical religion.

Further, your hypo only works because you added the artificial constraint about this being the only job the employee can get, which is what gives the employer such control. Take this restriction away, and it speaks to a baseline assumption that the employer does not have such control and is therefore not enabling.

Here’s where the right to work aspect comes in. Even as ill-defined as it is, it provides the analytical tools for this analysis. One of the principles of rights analysis is that people should not be denied a “lesser” right for exercising a “greater” right. Free exercise of religion is situated near the top of the rights heap. Rights analysis says an otherwise acceptable employee should not be fired for exercising his right to free exercise of religion. This statement is tempered by the needs of employers, which is why the phrase “reasonable accommodation” is used – it weighs the business needs against the burden placed on the right. It’s also why the rules only apply to businesses of certain size. Small businesses likely lack the staff needed to ensure the flexibility needed. A good boss will still try to accommodate.

quote:
You say there is 'a difference between being actively forced to participate in a morally unsound act and not actively seeking to prevent someone from obeying their own conscience.' The thing is, Dagonee, is that people who are seeking abortions are obeying their conscience. If we assume there is no other doctor close by (for the sake of argument),the doctor or nurse or whatever holds the same kind of power over the person seeking the abortion that the boss does over the person seeking the day off. That is, they can enable that person's particular ethical choice being carried out.
Again, the only reason the boss is “enabling” is because we postulated control over the employee that we generally don’t grant. By removing that control, we remove any moral responsibility for it.

However, abortion is a different matter. Unless an employer uses 100% of his staff 100% of the time, he is giving someone that day off. The accommodation principle just says preference should be given to those who need it for a religious holiday. Nothing unusual is being done.

Abortion, on the other hand, is an act that the doctor would not normally ever perform. He is being asked to choose between his livelihood and his religious beliefs. Because of the emergency procedure exception, he is not endangering any lives. Further, he is not creating any serious difficulty in job scheduling.

As to balancing the consciences of the abortion seeker and the would-be abortion provider, how do you decide when one person’s conscience should trump another’s? I think the one who require a positive action from the other almost has to lose if we are to maintain a society where people can meaningfully hold opposing ethical principles.

quote:
I'm really just looking at the issue. Remember, it's me you're talking to and not certain other people.
I meant my remark about your thread as a compliment, because I thought it represented a good understanding of the balancing necessary to allow such diverse moral and religious philosophies to flourish in this country.

quote:
Let's say that just like most abortion cases, the gay person isn't going to die.
Then the distinction is the doing v. not-doing. If someone’s ethics prompt them to avoid performing an act, that should be honored as much as possible. However, if it is not the act which is reprehensible, then we place the right to medical care above the providers. Again, it’s a balancing test.

quote:
By the way, I don't believe the bill gives doctors the ability to say no if the abortion is life saving?
No it doesn’t. This is based on the rescue principle. If someone puts themselves in a position so as to exclude the possibility of others rescuing a person in duty, they have assumed a duty to rescue the endangered person. A doctor placing himself in a spot that might have been filled by someone willing to perform a lifesaving procedure cannot exercise his right to refuse in that situation. Fortunately such circumstances are very rare.

quote:
I didn't even say anything about healthcare this time.

Basically, is it safe to say that you believe that freedom of conscience really isn't an issue except in the cases where we are talking about 'life'? And that outside of these cases, a person doesn't have the right to refuse to treat or do business with someone, even if they believe that their 'lifestyle' is morally wrong?

Not quite. First, it’s not just life. A person should, in general, not be forced to perform actions they find objectionable. In this portion of the analysis we’re concentrating on the actions, not the surrounding circumstances or people.

In general, people should be allowed to do what they want, including interacting with people of their choice. But in public commercial settings, such distinctions can interfere with a person’s ability to carry on the basic functions of life. Therefore, restrictions should be allowed when, in the balance, the weight on the conscience warrants it.

I have very strong libertarian leanings in this respect. This is an exception to those leanings that represents a balancing of concerns.

Dagonee
*I just do, that’s why. [Smile]

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Ela
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Just for the record, from the Miami Herald article yesterday:
quote:
The Michigan State Medical Society objects to the legislation.

''We don't believe it's necessary. Medical ethics has dictated for decades, if not centuries, that a physician isn't required to do anything that's against his or her morals,'' spokesman David Fox said.


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sndrake
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Ela,

I think the bill applies to a larger group of professionals than physicians. I'm pretty sure nurses don't enjoy that same degree of autonomy in terms of being able to refuse to engage in practices that go against their moral beliefs or standards.

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Dagonee
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medical ethics do not control the tort system, and part of this is protection from suit by patients denied a particular procedure.

Dagonee

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Storm Saxon
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Dagonee, thanks for your reply. I don't know if I'll reply, but I'll definitely chew on what you said.
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