HHS Secretary Mike Leavitt said the reg is meant to cover abortion, birth control, emergency contraception, in vitro fertilization, stem cell research or assisted suicide.

The language of the regulation has no restriction or limitation of any kind, not even for emergency situations, so any medical procedure, prescription, service, education, etc. can be refused on the basis of the provider's objection. Providers also can refuse to make referrals, or other arrangements for "offending procedures". (notice it's the procedures that are offending, not the people who are offended) Refusal to treat Ice-Floe Eligibles would presumably be included.

Defining which employees are covered:

When applying the term “assist in the performance” to members of an entity’s workforce, the Department proposes to include participation in any activity with a reasonable connection to the objectionable procedure, including referrals, training, and other arrangements for offending procedures. For example, an operating room nurse would assist in the performance of surgical procedures; an employee whose task it is to clean the instruments used in a particular procedure would be considered to assist in the performance of the particular procedure.

So, can the receptionist refuse to books appointments for an 'objectionable procedure'? Can the housekeeping staff refuse to clean a room where an 'objectionable procedure' is performed? Can I get a gig as an assistant of some sort at a fertility clinic and then refuse to do any part of my job whatsoever based on my 'conscience'? Bc if so, I'm thinking career change, why should I have to actually work for a paycheck? (but I digress...)

Here's the rationale for why the reg wins on a cost/benefit analysis:

An underlying assumption of this regulation is that the health care industry, including entities receiving Department funds, will benefit from more diverse and inclusive workforces by informing health care workers of their rights and fostering an environment in which individuals and organizations from many different faiths, cultures, and philosophical backgrounds are encouraged to participate. As a result, we cannot accurately account for all of the regulation’s future benefits, but the Department believes the future benefits will exceed the costs of complying with the regulation.

Short: We Have Always Been at War with Eastasia.

Bush et al, constant foes of what they consider judicial interference, have created a new right upon which to base the regulation, the "right of conscience." As far as I can tell the right of conscience does not extend to a refusal to pay taxes for a corrupt war, a corrupt administration, or the general corrupt fuckwittedness of the Bush administration, but I'll keep looking.

Evidently the regulation goes into effect just a day or two before Jan. 20. I am hoping, but not counting on, one of (any of) the major feminist or civil rights orgs will legally challenge the promulgation and delay the reg just a few days. I have no faith that Obama would reverse the regulation once in office, but he might, just might allow it to sink into oblivion. (or am I being too hopeful?)

I don't think they are required to provide particular medical services or prescriptions as part of licensing.

They are prohibited from discriminating against patients or customers for the same reasons that other private businesses are by Title VII or state law (on the basis of gender, race, national origin, etc.), but they are not required to provide any particular services. At least, I used to work vaguely in this area and have never heard of such requirements, aside from a few relatively narrow situations.

Physicians at least, and med students in training, have been able to refuse to perform abortions or sterilizations without adverse effect on their employment or education since the Church Amendments back in the 1970s. Even without those laws, though, I think for physicians this sort of thing would tend to work itself out with referrals to colleagues and such.

This reg is much more aimed at employment relationships, esp. now that so many physicians work for hmos, and with the rise of mega-corp owned pharmacies and in-store pharmacies. Not that employers (Target, Walmart) have done any great favors to opponents of the regulation, but there aren't, say a lot of indpendently owned pharmacies anymore where Joe Pharmacist could just quietly refuse to stock birth control pills, everyone knew it, and people would go elsewhere. Now Walmart management gets to decide whether to fire you or dock your pay. While I doubt most corporate overlords would oppose the regulation on the basis of the right of patients or customers to received care or services, they would mightly object to any sort of employee-controlled job responsibility exceptionalism. From a management and cost control perspective, this is a freakin' nightmare. What if the only pharmacy assistant you have to cover the midnight shift at your 24-hour CVS refuses to fill any prescriptions for drugs developed using animal testing?

By the way, surfing around, I found that the American Medical Association, the American Hospital Association, the American College of Obstetricians and Gynecologists, the American Nurses Association, American Academy of Pediatrics and the American Psychiatric Association, and at least 27 state medical societies oppose the regulation.

i bet they won't tho.

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