A Senate committee has approved the proposal extending the freedom of conscience to pharmacists and other health care workers in circumstances involving emergency contraception and end of life care.
“It really is an issue dealing with the right of an individual to exercise their right of conscience,” Sen. Chuck Winder, R-Boise, told the Senate State Affairs Committee. That freedom of conscience applies to services involving abortion, emergency contraception, stem cell treatment, and end of life care and treatment. Hospitals and hospital employees currently have such conscience rights. Winder said expanding those rights will correct an oversight, but won’t limit care to Idahoans. “The intent of this legislation is not to restrict or limit, in any way, health care services to women or men in Idaho.”
A similar measure, targeted specifically at pharmacists, failed to get out of the Senate Health and Welfare Committee last year. Senate President Pro Tem Robert Geddes, R-Soda Springs, said moving the plan through the state affairs committee isn’t much of a switch. “It’s not a big deal,” he said. “It’s just where it went this year.” The proposal now heads to the full Senate for a vote.
Winder said he attempted to improve on last year’s proposal and compromise with all sides of the issue. “While we were not able to resolve all of their collective concerns, we were able to address most of them,” he said. “We felt that if we did accommodate all of the objections that it would have defeated the intent of our proposed legislation.”
“Obviously there’s not unanimous support, but it was not done in a vacuum,” said Sen. Russ Fulcher, R-Meridian. “This legislation prohibits nothing. It does allow professionals to opt out of something they don't want to do.”
Senate Minority Leader Kate Kelly, D-Boise, opposed the plan. She said it’s a move to curb access to health care, and comes just as the Senate is set to vote on the Health Freedom Act. “The Health Freedom Act declares that every person within the state of Idaho shall be free to choose or decline their mode of health care services,” she said. “In our state, health care freedom applies to every person except if you’re a woman of child-bearing age who wants the freedom to access perfectly legal, over-the-counter medicine. It doesn’t apply, apparently, to seniors who are facing end of life decisions … I think that’s a huge concern.”
The proposed legislation would require health care workers to give written notice to their employers about what procedures they morally oppose and protects workers and employers from criminal or civil action for following their conscience. Barbara Jorden with the Idaho Trial Lawyers Association objected to this immunity given to health care employers and employees, saying it would open up a "big can of worms" because that protection is ambiguous.
“By protecting the conscience rights of our doctors, nurses, and pharmacists, we are really protecting ourselves,” said David Ripley, executive director of Idaho Chooses Life. He said he preferred last year’s plan that provided more defined, “iron-clad” protections solely for pharmacists. The proposed law would require pharmacists and other workers to provide health care in a life-threatening situation if another worker isn’t available. “This legislation is broader in some sense than last year’s bill dealing with pharmacists, but in some sense it’s much narrower.“ The proposal is limited to what he called most “morally potent areas” of medicine, dealing with abortion and end of life care, but not other ethical issues like drugs that are tested on animals. Will Rainford with the Catholic Charities of Idaho said dispensing drugs that with the potential to end life could lead to a “crushing guilt” for Catholic health care workers.
Supporters of the proposal say it won’t affect health care in small towns with few pharmacies. Chris Troupis, an attorney for Idaho Chooses Life who worked with Winder on writing the legislation, said pharmacies in small towns could potentially not hire pharmacists who would be unwilling to perform some services. “If it means the denial of that service to that community that the pharmacy is providing, then the pharmacy can use that fact to elect not to hire that individual,” he said.
“The pharmacist would need to consult with their attorney before hiring any employee,” Kelly told Troupis. “That sounds like a huge burden.” Troupis said employers would have to make difficult decisions, but that they consult with lawyers on many issues.
Pro-choice groups opposed the conscience rights plan. “This protection is unnecessary,” said Marty Durand with Planned Parenthood of Idaho. She told lawmakers that only doctors – not pharmacists – can give patients RU-486, a drug that ends a pregnancy. Pharmacists can give patients Plan B, an over-the-counter emergency contraception drug that can prevent pregnancy. Winder’s legislation calls emergency contraception a drug that causes an abortion. “A pharmacist cannot dispense medication for the purpose of terminating a pregnancy,” Durand said.
“This bill will have a disparate impact for women in Idaho, especially in rural areas,” said Taryn Magrini, public policy director for the Idaho Women’s Network. “We need to keep all forms of contraception, including emergency contraception, available to women all over the state.”
Democrats on the panel agreed with Durand.
“Emergency contraception is not an abortion pill,” said Sen. Michelle Stennett, D-Ketchum.
Ripley responded to Stennett that some pharmacists have conscientious concerns about Plan B. “There are many health care providers that are concerned about the moral implications of emergency contraception.”