A new Florida law provides conscience protection for healthcare workers
During the recent legislative session, the State of Florida witnessed the passing of a law that provides conscience protection to healthcare workers. SB 1580 and its House companion HB 1403 provide healthcare workers with the right to opt out of participation in any healthcare service based on a conflict of conscience.
"Nothing in this bill allows a medical professional to decline to serve a patient because of who they are," said bill sponsor Senator Jay Trumbull in his closing statement. "Rather, it specifically focuses on what procedure the doctor or nurse is asked to perform and protects them from performing anything that violates their religious, moral or ethical beliefs."
This law is an important step in securing the very foundation of the doctor-patient relationship.
Primum non nocere
The medical tradition of the Western world is traced to the ancient Greeks, the School of Hippocrates, and the Hippocratic Oath. The Oath introduced the concept of the practice of medicine as a moral obligation to the patient. The physician declared to do good, never to harm the patient, and to refrain from injustice and corruption.
The doctor-patient encounter is therefore the foundation of the practice of medicine. The bond of trust between physician and patient is the basis of the doctor-patient encounter. Trust that the medical intervention will be of benefit to the patient and trust that the patient will follow the advice of the physician.
The physician pledges to be his patient’s advocate. The patient must trust the physician will act in his/her best interest. The physician promises an accurate diagnosis and the best possible treatment plan. It is when the doctor-patient partnership is based on mutual trust that the best deliberation can be attained with both partners satisfied with the outcome.
The healthcare worker who is faced with a patient’s request for a treatment plan or a procedure that violates his/her religious, moral, or ethical beliefs will, in due conscience, not be able to comply with the patient’s request.
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It is necessary that the patient is informed of the physician’s moral beliefs at the start of the encounter or, even better, before the encounter. I believe that most patients would respect the physician’s decision and understand that to comply would betray his moral convictions. The patient must be convinced the healthcare worker is acting in good faith and that he/she is committed to do no harm.
Against the procedure, not the patient
Some have said that refusing a patient’s request on moral grounds could result in negligent medical practice. The claim is made that negligence is based on discrimination against the patient because of who he or she is. However, the physician declines a procedure; there is no ill will to the person. The procedure solicited is considered by the physician to be contrary to his or her ethical beliefs and harmful to the patient. The physician is acting in the patient’s best interest. The Florida law clearly states that the focus is the procedure, not the patient.
Many times, those that reproach the physician for discrimination against the patient are ethicists, not physicians. However, the clinical relationship is between the doctor and his patient, and I propose the two parties involved ought to be allowed to work the discrepancy without interference.
The covenant relationship of the doctor-patient encounter must be based on trust to be successful. The trust must be based on the respect that each must have for the moral, ethical beliefs of the other. The doctor, first, promises to do no harm.
The freedom of conscience of the healthcare worker affirmed in this new law in the state of Florida is the condition that ensures the free practice of medicine. I suspect the patient would appreciate a free provider who stands firmly on his moral integrity.
Dr Vizcarrondo is a retired pediatrician and faculty member at the Institute for Bioethics and Health Policy, Miller School of Medicine, University of Miami, Florida.
Image Credit: Pexels
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