Bush, in final gesture, boosts ‘moral’ protections

WASHINGTON —A month before leaving office and a week before Christmas, the Bush administration left a parting “gift” on community pharmacy’s doorstep. But for retail pharmacy operators, the gift looks more like a lump of coal.

In a move opposed by many healthcare advocates, physicians and pharmacy operators, the White House issued new “provider conscience” rules to formally protect doctors, pharmacists and other healthcare workers who refuse to serve patients on moral grounds.

The new protections, announced by the Department of Health and Human Services, were set to take effect this month in the final days of the Bush White House. In effect, they would strengthen rules already in place to prevent health-care institutions, retail pharmacies and other provider organizations from discriminating against workers who refuse to provide services on the basis of conscience, such as abortions or the dispensing of emergency contraceptives.

To do so, HHS would wield a potent weapon: the withholding of any federal funds to health providers who take any action against workers who refuse to serve patients because of their moral beliefs. “Doctors and other healthcare providers should not be forced to choose between good professional standing and violating their conscience,” said HHS secretary Mike Leavitt.

Many health advocacy groups oppose the administration’s 11th-hour move, fearing that it could disrupt needed health services for patients, such as counseling about birth-control options. They fear the rules also would protect pharmacy workers who refuse to dispense birth control pills from any disciplinary action by their employers.

Also likely to oppose the measure is the new occupant of the White House and many members of Congress. President-elect Barack Obama was critical of the Bush “right of conscience” rule when the outgoing president proposed it last summer, and Obama has pledged to review all last-minute regulations issued by President Bush once he takes office this month.

Concern over the new rules also came from the Human Rights Campaign, a Washington-based advocacy group.

“These regulations sacrifice patients’ rights to medical care, permitting providers to refuse to do their jobs,” said HRC president Joe Solmonese.

Under the new rules, said Solmonese, “a provider might be able to refuse to administer an HIV test to a gay patient, and even be exempt from the statutory duty to tell the patient where else he could receive the test.

“The regulations would also threaten women’s access to comprehensive health care by permitting pharmacists to refuse to dispense contraception, even when doing so significantly burdens the patient’s access.