Wisconsin "conscience clause" bill gets rapped as bad policy

The state medical society opposes the bill allowing doctors to opt out of certain procedures because it doesn't require a referral to another physician.

By Andis Robeznieks, amednews staff. Aug. 4, 2003.

A "conscience clause" bill passed by the lower house of the Wisconsin Legislature would go further than an existing law which allows health care professionals to opt out of participating in abortions and sterilization procedures, and it would extend the right to refuse into such arenas as embryonic stem cell research and end-of-life care.

The National Abortion and Reproductive Rights Action League reports that 45 states have some sort of "refusal clause" allowing medical personnel to opt out of participating in abortions.

What troubles opponents of the Wisconsin bill is that it doesn't require physicians to refer patients to another doctor and that it may lead to access-to-care problems for patients in small communities.

Mark Grapentine, Wisconsin Medical Society legislative counsel, said that the debate has almost become a law school seminar where participants debate "what-could-happen ifs," but he said the way the bill is written invites unintended consequences, especially in end-of-life care.

One particular concern is that the bill would allow physicians to refuse to withdraw feeding tubes from a terminally ill patient even if that patient's advance-care directive or living will calls for them to be withdrawn.

And that's especially troubling to some end-of-life care groups.

"We are absolutely opposed to not following a patient's wishes," said Melanie G. Ramey, executive director of the Hospice Organization and Palliative Experts of Wisconsin. "They [bill supporters] have been antsing and dancing around trying to explain what it says, but we can read English."

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