Homo homini rodentius est

Journalist, do no harm

Religious DoctorsThere’s a [prominent boxed story] on the front page of the Washington Post today entitled, “A Medical Crisis of Conscience”, by Rob Stein. The subtitle of the main story is “Faith Drives Some To Refuse Patients Medication or Care” and states that an increasing number of healthcare providers are refusing to offer certain controversial services, such as abortion drugs, because it conflicts with their moral and religious beliefs. The tone of the article is a little overheated, suggesting that doctors have not previously shied away from patients or situations that they found objectionable and, through careful omission of detail, makes the reader think the problem is more general in its effects than it probably is.

The story has the familiar hallmarks of “trend journalism”, where a few examples, liberally seasoned with grab quotes from “experts” are cooked up into a souffle of national “crisis”. Stein presents just four examples of healthcare workers who withheld services: an ambulance driver who would not transport a woman to have an abortion, “fertility specialists” (2, 10, 100?) who would not assist a lesbian with artificial insemination, a pharmacist who would not provide the morning after pill to a rape victim, and a nurse who won’t dispense abortifacients. Though the writer opines that the problem is serious and will only get more serious as new controversial therapies related to stem cells, etc. come up, it’s pretty clear this is primarily about abortion — with maybe a sprinkling of homophobia for good measure. This is news?

Maybe to Stein it is. I grew up in a small town in upstate New York where social conventions were, well, conventional — and internalized. I have a feeling that more than a few young women seeking abortions as a method of birth control would have traveled out of town to Albany to get a service that they would have felt uncomfortable asking from their local physician — if it was even provided. Right or wrong, my point is that there is nothing new to this. The more interesting question from a journalistic point of view would have been the regional character of this “crisis”, and how it relates to socio-economic level. One can look for hints about these factors in the Washington Post story — a number of the healthcare workers are from the south or midwest, as is the one patient quoted — but it is not addressed directly. Harder to make the case that this is a national issue, if it tends to happen more where one would expect it to happen — in the Bible Belt.

The bias of the writer is showing in the way he fails to detail even the specific cases he cites as evidence. The situation of the pharmacist who denied the abortifacient to the rape victim stands out by contrast as this is counter to what most people would consider morally acceptable. But the other cases seem less stark, more along the lines of social control: discouraging behavior (such as abortion as a method of birth control) by making it difficult. Not impossible. As Stein notes, patients do get the services they want, but from other people. I see nothing wrong with this. I suspect Stein does — he wants care providers to leave their moral and religious beliefs at the door of the examination room and pharmacy. You can often tell the writer’s bias by reading the penultimate paragraphs in a story like this — that’s the point in the arc of a story where the writer presents the view he wants you to take away, often couched in carefully chosen quotes or things like “Others say…”. In this case, we are left with “Others” who “say that professional responsibility [to provide controversial services] trumps personal belief”. Further, “Doctors, nurses and other health-care workers who cannot find a way to fulfill their responsibilities should chose [sic] other professions, some say.” Got it, Rob.

Small wonder people brand the media as liberally biased. There could well be an interesting story here, about the types of services (e.g. abortion in toto, vs. as a method of morning after birth control) that people are refusing to deliver, where it’s really happening and what the implications for social effects are (e.g., do unwanted pregnancies decrease in an area where abortion as a method of birth control is made more difficult?). Maybe someone at the Washington Post will do more footwork to find out for us.

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