Joseph Fletcher Would Be Proud

April 9, 2009

In 1954, Joseph Fletcher, father of “Situational Ethics” wrote, “[W]e shall attempt, as reasonably as may be, to plead the ethical case for our human rights (certain conditions being satisfied) to use contraceptives, to seek insemination anonymously from a donor, to be sterilized, and to receive a merciful death from a medically competent euthanasiast.”
Morals and Medicine, (Boston: Beacon Press, 1954), p. 25

Today, 9 April 2009, is the final day for the public to make comments regarding the right of conscience protections for health care workers put in place by the federal government late last year. There is a planned recission, or cancellation, of those regulations defending right of conscience for health care workers. The public has had thirty days to comment on the planned recission, and that comment period ends tonight.

Comments are invited thru today to be posted at “Regulations.gov Your voice in federal decision making”. What kind of comments is the government interested in receiving? Four kinds are paraphrased here:

1. Information, including examples, whereby there is need for federal rulemaking, and
   “how the current rule would resolve those problems”
2. Information, including examples, supporting/refuting allegations that “access to
   information and health care services, particularly by low-income women” is reduced
   by the conscience protection regulations
3. Comment on clarity of the rule: will it “minimize the potential for harm resulting
   from any ambiguity and confusion that may exist because of the rule”?
4. Comment on whether the conscience protection regulations’ objectives could be
   “accomplished through non-regulatory means, such as outreach and education”

Let’s think for a few minutes. Here are a few conclusions we might reach, based on the requests for comments:

1. The current administration apparently doesn’t believe any of the previous comments
   regarding pressure to go against deeply held convictions, or discrimination and/or
   harassment experienced by health care professionals who object to procedures like
   abortion or physician-assisted suicide.
2. The regulations went partially into effect on 20 January 2009, with the remainder to
   be put into effect over succeeding months. This information will be limited at best.
3. Is the administration serious with this convoluted question? It would be far more
   helpful to comment on the clarity of this question, which is minimal, even by
   bureaucratic standards!
4. Would the administration have asked Dr. Martin Luther King, Jr. whether civil rights
   could be accomplished through “non-regulatory means, such as outreach and
   education”? Dr. King’s response to such a question would make interesting reading
   today.

After today, we will likely be much closer to Joseph Fletcher’s so-called human rights to use contraceptives, have insemination by donors, be sterilized, and receive death at the hands of physicians. These physicians will have fewer civil rights, and perhaps, one day, be devoid of conscience. As physicians and other health care professionals with conscience are increasingly marginalized and leave the professions, there will be stark changes in the landscape of health care. These changes would make Joseph Fletcher smile, and Martin Luther King, Jr. weep. And they would show the truth of William Shakespeare’s words: “The evil that men do lives after them; the good is oft interred with their bones.”