Saturday, 11 April 2009

Health care, or just preying on the sick?

April 9 was the final day in the USA for public comment on a proposal to rescind an ugly faith-biased health regulation, the "provider conscience rule", which slipped in right at the end of the Bush era.
It’s a nasty little get-out clause for superstitious bigots which permits health workers at hundreds of thousands of federally funded clinics to refuse to provide health information and services related to abortion and other procedures they find objectionable. For example, an emergency room doctor at a federally funded hospital could claim the right to refuse rape victims information about emergency contraception, if doing so would offend the doctor's beliefs.
Crucially, there is no provision for considering and addressing the impact of such refusals on patients, and it doesn’t require the clinics to ensure that women receive essential health information and care despite the bigots in question.
There is also no provision for exceptions to the rule or other alternatives in the case of a need for lifesaving procedures or other emergencies, and the regulation does not require a referral to another employee who does not object and can carry out the procedure.
You can find out more courtesy of Human Rights Watch at
While in theory things are more flexible in the UK, in practice it’s something you still need to watch for –especially here in the Isle of Man.
I’ve already blogged on religious prejudice blocking Manx access to pregnancy termination (see From Third World to Romania, with ignorance), and in addition I strongly advise anyone rational and terminally ill to avoid the local Hospice. From experiences relayed by various friends the chances of anyone dying there in a way which doesn’t suit certain faith-biased bigots are non-existent.
Frankly I expect nothing anyway from a place which juggles Manx charitable and ‘independent’ health status in order to avoid the common decencies you’d expect at a pukka public health facility. But sadly this twaddle is spreading to the Manx NHS too.
In theory, while living wills have no firm legal status here because there is no Manx equivalent to the UK’s law on mental competency, living wills are recognised as ‘best practice’ and NHS staff expected to respect them. Yet only three months ago I am reliably informed a woman who made such an advance directive well before showing the first signs of dementia had her wishes blatently ignored by un-named NHS staff, who must have included at least one consultant. Her directive was supported by her immediate relatives, yet someone determined to ‘save her life’ by inflicting an invasive procedure on her phoned through a long list of relatives until finding one prepared to agree with ‘the expert’, not the woman and those she chose to take difficult decisions in the case of her inability to do so.
It is a troubling case, and I’m assured all decent senior Nobles staff were disgusted. Sadly, under current circumstances, the chances of ordinary Manx people being safe against medical decisions based on religious bigotry being quietly implemented by a few NHS staff are slim. Yet one more area locally where church claims to ‘moral authority’ or even 'humanity' have to be unmasked as nonsense and abolished if we are ever to get decent public services delivered.

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