A thought on the “Conscience Clause”

Crossposted on my blog, Apathetic in Alberta

After reading this post by Alberta Altruist, I scrapped my work on “The Perils of Online Voting” (which was a whole mess of chaos, best saved for another time), and decided to tackle one of the subjects I am most passionate about: reproductive health. Only because I had no desire to clog up his comments section with my never-ending diatribe on the issue.

This need to discuss what is essentially a dead dog in Canada arises out of the New Wild Rose Alliance party’s policy that, if elected, they would: “Implement legislation protecting the ‘conscience rights’ of health care professionals”

Basically, this means that if a doctor finds the procedure you are hoping to get (I’m assuming this only applies to elective procedures) to be irreconcilable with their personal morals, they are not obligated to provide the patient with that medical service. This is all a lot of flourish to essentially give doctors the out on providing abortions or prescriptions for birth control. I mean, what are the chances that my GP is going to find my tonsillectomy morally repugnant? Pr-e-tt-y slim. These clauses always clamp down on JUST reproductive health. 

I am going to step away from the issue of abortion that I brought up originally for 2 reasons:

1. Abortion provision is basically a specialized procedure anyway, and is only provided in hospitals (6 of 100) and reproductive health clinics. You don’t go to your GP for a D&C.

2. Abortion can be a divisive issue, and other non policy-related arguments tend to derail the conversation.

So lets talk about contraception and sterilization. Conscience clauses would give my doctor the right to refuse me birth control if they believed that my pre-marital sexual activity was against their beliefs (slattern! It’s for your own good!) Or, if they thought any form of birth control is contrary to God’s plan for my body. These thoughts make me prickle on their very own (what’s with your sense of entitlement? jeez), but even so, I live in Edmonton and I have a car. I can find another doctor who is not so insane – no offense.

I don’t make a whole ton of money, but I do have a certain amount of privilege in that I live in a large urban center and have a personal mode of transportation. Switching doctors = not really a problem. However, I personally just spent nearly a year trying to find a GP who takes new patients, and is knowledgeable about my needs. A year. I live downtown, and this doctor’s office is west of Collingwood (on the west side of the Anthony Henday, for those out-of-towners). Finding a physician in this city is not easy. Were I a working-poor, mother of 3 who takes the bus everywhere, finding another doctor would be approaching impossible. 

“But Chelsa!” you say, “There are walk-in clinics scattered all across this great land!” And to you I say, I know. I’ve sat in them. For 3-4 hours (I also say to you, don’t start sentences with conjunctions). 3-4 hours for someone working minimum wage to support a family is a lifetime. And maybe a power bill or groceries.

Additionally, most physicians will NOT give out birth control to someone who has not had their annual fun time, known as the “Pap Smear”. Getting a pap at the walk-in: not really ideal. 

So even in the city, conscience clauses would have ramifications. Rural areas? Multiply that. Like, a lot.

Add to that, that free markets do not always function as theory suggests, especially in rural/remote areas. While I think it’s patently optimistic to hope that the doctor or pharmacist that refuses to write or fill contraception scripts would eventually be run out of business by another, more savvy opportunist, that’s not the way it works in reality. In reality, a small town may have one clinic and one pharmacy that serves a fairly large municipal district. In this case, a clinic or pharmacy cannot realistically be “protested”, because these services are all but mandatory and the closest alternative is an hour away. No matter how mad one is about lack of access to contraception, there’s not really a way for them to be a good consumer and “vote with their dollar” elsewhere.

You can see the fallout in cases such as the tubal ligation ban in Humbodlt, Saskatchewan. In this case, getting to an urban center that would perform the procedure means a 230km round-trip plus accommodations. For some women, that’s a mountain. Or perhaps the woman who was denied birth control in the US (let’s not fool ourselves… the WRA is taking this policy straight from the pages of our conservative neighbours to the south), because her physician felt it would cause emotional trauma due to multiple partners. Which, will inevitably be the result of contraceptive use. Can you hear my eyes rolling from where you’re sitting?

I don’t need to mince words, here: These situations WILL happen, and lack of access to contraception leads to increases in abortion rates… which are publicly funded, fyi.

To sum it all up, conscience clauses undermine equitable access to healthcare in this province, and frankly, we’re having enough trouble with that as it is. If people would stop thinking about reproductive health as just a “women’s issue” and consider it a community issue (which it is. ‘nother post, ‘nother time), maybe we would be less likely to throw this aspect of healthcare under the bus for some empty accolades and “moral high ground”.

Do I think doctors should be obligated to provide services they are morally offended by? I refer you to the parable of the vegetarian server working at a steak house. Or more realistically, the story of the Justice of the Peace who was fired (only a few months ago!) after refusing to marry an interracial couple – you know, for the potential kids’ sake.

Do your job and keep your morality away from my uterus.