First do no harm: People, as well as politics, are crucial when covering medical conscience fights

It's one of the most famous phrases in the world of medical ethics: "primum non nocere." That's Latin, of course. It means, "First do no harm."

Ah, but who gets to make the ultimate decision about whether a particular medical procedure or strategy for care will do harm to a patient? Is that ethical/moral call up to the patient, the doctor, the doctor's boss, an insurance company or even lawyers representing the U.S. government?

Now flip that question around. What if doctors pledged something like this: "First, do good." Who gets to decide what is good? Clearly, there are legal, ethical and, yes, religious questions linked to these decisions and that has been the case for centuries.

So let's pull these ancient questions and values into our litigious age.

A patient requests an abortion, perhaps even in the second or third trimester. The doctor (or perhaps a nurse) is an orthodox Catholic, a Mormon, a traditional Muslim, an Eastern Orthodox Christian, an Orthodox Jew or someone else with a deep and consistent belief that it would be wrong, a mortal sin even, to take part in this procedure. Some questions linked to medical care for trans patients, especially children, would create a similar ethical/theological crisis. Doctors do not agree on what causes "harm." Many disagree on what is "good."

How do reporters cover stories linked to these debates? First, do no journalistic harm?

Hold that thought. Here is the top of a Washington Post feature -- from the national desk, not the religion team -- on this semi-new front in America's culture wars.

The Trump administration will create a new conscience and religious freedom division within the Health and Human Services Department to ease the way for doctors, nurses and other medical professionals to opt out of providing services that violate their moral or religious beliefs.
Specific details are scheduled to be announced Thursday. But the new policy appears to be broad and aimed at protecting health-care workers who cite those reasons for refusing to take part in abortions, treat transgender patients or participate in other types of care.
Conservative groups praised the move Wednesday as upholding providers’ right to religious liberty.
“We think the Trump administration should set an example in enforcing the multiple conscience laws that have been passed since the 1970s to prevent the government from punishing people who have objections to participating in abortions,” said David Christensen, vice president of government affairs at the Family Research Council.

What is at stake here?

Quite literally, the question is whether traditional, orthodox believers in many faiths have a right to be doctors and nurses in mainstream hospitals -- without violating the doctrines of their faith. Eventually, of course, questions will be raised about private religious institutions being required to provide medical procedures and treatments requested by patients.

One side sees a crisis linked to conscience and religious liberty. The other side sees discrimination and attacks on sexual liberty. Sound familiar?

So what did the Post team need to do here? From a GetReligion point of view, the main journalistic goal was to provide fair, accurate coverage of beliefs on both sides of this debate -- treating people on both sides with respect.

Remember that famous 2003 Los Angeles Times memo on abortion coverage? The late editor John Carroll wrote the following to his section editors:

We may happen to live in a political atmosphere that is suffused with liberal values (and is unreflective of the nation as a whole), but we are not going to push a liberal agenda in the news pages of the Times. 

I'm no expert on abortion, but I know enough to believe that it presents a profound philosophical, religious and scientific question, and I respect people on both sides of the debate. A newspaper that is intelligent and fair-minded will do the same.

Respect for religion, science and philosophy. Intelligence. Attempting to be "fair-minded."

"Amen," I say.

The Post national-desk story did a fine job of tracing policies on these questions back into the George W. Bush and Barack Obama eras. This political information is predictable, but essential.

The story also quotes activists on both sides of the issue, with about 100 words of commentary on the cultural right and 350 words on the cultural left. Of course, one could argue that attempts to describe the new HHS policy itself can be considered conservative information. Take, for example, this crucial bit of background:

“Conscience” protections have been around for decades, whether in state statutes or as part of hospital policies, but some health-care providers have said those have not been enough to protect them.
In 2009, Cathy Cenzon-DeCarlo, a nurse at Mount Sinai Hospital in New York, was forced to assist in a second-term abortion or face disciplinary action. She sued, but a court rejected her claim that Mount Sinai had violated federal protections because it received nearly $375 million in research funding from the National Institutes of Health. DeCarlo’s complaint with the HHS Office of Civil Rights was not addressed until 2013, when the hospital changed its policies and procedures so employees were no longer forced to participate in abortions over their objections.

So what is missing?

Quite frankly, I was amazed that this story focused almost exclusively on the politics of all this, as opposed to seeking some input from medical professionals and patients who have been caught up in these clashes.

For example, what -- precisely -- does it mean to say that Cenzon-DeCarlo "was forced to assist" in a second-trimester abortion? What kind of disciplinary action did she face? The loss of her job? Are there actually cases in which the religious convictions of one or more medical professionals have prevented procedures from taking place?

Looming in the background are even bigger issues, for religion-beat pros.

At some point, will the government be tempted to declare that religion is strictly a private affair centering on feelings and vague beliefs and, in all public debates, must yield to "real" rights and "real" desires? Is religious faith just a kind of "hobby"?

If that is the case, could we reach the stage where -- by legal definition -- all attempts to protect the rights of orthodox religious minorities in medical professions are viewed as causing some kind of "harm" to patients? What about law? Counseling?

Dear editors: Yes, that is a political story, a medical story and a legal story. But it is also a religion story and it should be covered that way.

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