Texas Medical Association doesn't support conscience

This TMA press release/"Alert" is a shallow statement which ignores the history and facts behind the ruling and addresses the right to conscience as though it is dependent on circumstances and can be "rescinded."

The individual right not to act is called "Liberty." As an inalienable right, liberty cannot be given away or taken. It cannot be "balanced" by actions of the State or by organized medicine, only infringed.

The ruling does cover emergencies and is only a clarification of the many laws in place at this time to protect the right not to act of health care professionals.

Was there any attempt to balance this opinion by contacting those in support of the ruling?

For more information on the Ruling and the (4 year or more) history behind it, see the many "conscience" articles at this blog and the information at Freedom2Care.

From the Texas Medical Association:

TMA Backs Rescinding 'Conscience' Rule

TMA, AMA, and state medical societies across the country support the Obama administration's plan to rescind a federal rule that prohibits recipients of federal funds from forcing physicians and other health care professionals to participate in actions they find religiously or morally objectionable.

In a letter to Acting Health and Human Services (HHS) Administrator Charles E. Johnson, the groups said the Conscience Rights of Health Care Providers regulation, adopted by the Bush administration in December, is unnecessary and could have far-reaching implications. They said it "could undermine patients' access to vital medical care and information, impede advances in biomedical research, and create confusion and uncertainty among physicians, other health care professionals, and health care institutions about their legal and ethical obligations to treat patients."

They wrote that they support "strong conscience protections" for physicians, residents, and medical students and other health professionals, especially when it comes to abortion. No physician, hospital, or hospital employee should be required to perform an act that violates good medical judgment or personally held moral principles. "However, while we support the legitimate conscience rights of individual health care professionals, the exercise of these rights must be balanced against the fundamental obligations of the medical profession and physicians' paramount responsibility and commitment to serving the needs of their patients. As advocates for our patients, we strongly support patients' access to comprehensive reproductive health care and freedom of communication between physicians and their patients, and oppose government interference in the practice of medicine or the use of health care funding mechanisms to deny established and accepted medical care to any segment of the population."

Other points in the letter include:

* Abortion education should be encouraged "so medical students receive a satisfactory knowledge of the medical, ethical, legal, and psychological principles associated with termination of pregnancy …" The letter adds that "the observation of, attendance at, or any direct or indirect participation in abortion should not be required." Resident training should include "specific educational standards for the knowledge and skills associated with pregnancy termination that allow an exclusion for individuals or residency programs with religious/moral objections or legal restrictions."
* Several provisions and definitions in the rule "are ambiguous, overly broad, and could lead to differing interpretations causing unnecessary confusion among health care institutions and professionals, thereby potentially impeding patients' access to needed health care services and information." The rule, for example, defines "health service program" as "any plan or program that provides health benefits, whether directly, through insurance, or otherwise, which is funded, in whole or in part" by HHS. "This definition inappropriately expands the scope of the conscience provisions beyond family planning and abortion services to include virtually any medical treatment or service, or biomedical and behavioral research," the letter says.
* The rule does not address how conscience rights of individuals and institutions apply in emergencies.

Texas Employees, Politics, and Science

(Just to be clear about where I'm coming from, I believe in a Creator and also believe that the evidence I've seen supports the evolution of species. When asked about evolution, I say, "It looks like that's how God did it." Now that I've alienated all but a few of my readers . . .)

The New York Times has an article today on the resignation of the Texas Education Agency (TEA) employee, Chris Comer. In my opinion, the NYT and the Austin American-Statesman focus on the wrong theme. The story is more about the politics of being a State employee than about the politics of science.

The blogosphere is full of comments relating her resignation to "creationists" and drawing an analogy to the movie, "Expelled."

However, there's a difference between speech and advocacy on scientific controversies while working in a academic position (even when paid by the State) and the same activity while working for a State Agency. While both should avoid frank political advocacy while on the State's time clock, the former is in the business of discussing and critiquing science. The Agency employee works directly for men and women who are themselves restrained by the voters of the State, who have their own politics.

The implication of the NYT piece is that Ms. Comer was under pressure due politics, the appointment of a new Chairman of the State Board of Education and the hiring of a woman who used to work for the Bush Administration. On further research, I found a possible connection between a statement that Ms. Comer made concerning the lack of "real" leadership at the TEA under an acting Commissioner and the appointment of the same man to the office of Commissioner.

In addition, it might help to know that the Texas Legislature recently mandated that each agency develop ethics policies.

Texas elects our State Board of Education, the Governor appoints (and the State Senate confirms) one of these elected officials to the Chair and he also appoints the Commissioner of the TEA. The TEA is the bureacracy that provides "leadership, guidance, and resources to help schools meet the educational needs of all students."

State employees are forbidden by policy to mix in politics while on the job and with State resources. At the very least, it's not wise to risk bringing pressure down on your appointed or elected bosses. The offense that led to Ms. Comer's resignation was sending an email from her TEA account that announced a talk entitled, "Creationism's Trojan Horse."

Ms. Comer and the author of the NYT article find something notable in the policy at TEA:

But several months ago, in response to an inquiry letter, Ms. Comer said she was instructed to strike her usual statement about the board’s support for teaching evolution and to quote instead the exact language of the high school biology standards as formulated for the Texas Essential Knowledge and Skills test.

“The student knows the theory of biological evolution,” the standards read, and is expected to “identify evidence of change in species using fossils, DNA sequences, anatomical similarities, physiological similarities and embryology,” as well as to “illustrate the results of natural selection in speciation, diversity, phylogeny, adaptation, behavior and extinction.”

I fail to see a problem in a policy requiring the quote. I would think that it would inform and educate any one with questions and protect State employees from political fallout.

Ms. Comer herself makes correlations between certain politically controversial subjects:

“I don’t see how I took a position by F.Y.I.-ing on a lecture like I F.Y.I. on global warming or stem-cell research,” Ms. Comer said.

And she did consider the email risky:

As for the e-mail, Comer said she did pause for a "half second" before sending it, but said she thought that because Forrest was a highly credentialed speaker, it would be OK.

For a step-by-step report about Ms. Comer's troubles at the TEA, see the Austin American-Statesman article and my earlier post.

Politics Bites

Chris Comer, Director of Science Curriculum for the Texas Education Agency (TEA) sent out an email from her State account that was blatantly political in nature and which she knew was a bad idea.

Surprise! So did her bosses.

She made the political move, and got fired for it. Really, advocating a lecture titled, "Inside Creationism's Trojan Horse," by Barbara Forrest, a well-known anti-Creationist. That's worse than "not neutral." The title of the lecture is blatantly political.

If you want to see a video of Forrest's lecture, this page hasa link to the video, "Barbara Forrest's Inside Creationism's Trojan Horse."

The Red-A blogger,Pharyngula, The Austin American Statesman, and Nature blogger, "The Great Beyond," among others are blaming the politics on the Texas Board of Education. "The Austringer" blogger has the text of the original memo that Ms. Comer sent out.

In my experience, Ms. Comer's boss has it right. In her memo to the Agency, she notes that Ms. Comer either violated what she knew is TEA policy against employees of the State advocating for a political cause or she does not have the understanding that she should. (There's a link to the memo from the boss on the Austin American Statesman link above, but theres some sort of glich in it - it tries to add Japanese script updates to my computer.)

(In the video, go to 1:01/1:09:52: "These people are fanatics. . . . They know they have to get hold of the kids." A little earlier, Forrest stated that the believers are guilty of projection. From this side, it looks like a case of "Pot, Kettle." The last thing Forrest speaks on is the need to watch out for which judges are appoint, the need to teach the teachers to tell students that belief in a Creator is bad science and that "We need to stop electing people who put up with this crap!")