Letters to the Editor - Nov. 24, 2008

Conscience law enforcement protects those making a crucial moral decision

Regarding "Activist veto of abortions will result if conscience laws enforced as proposed" (Letters, Oct. 20): The letter by Amesh Adalja, MD, of Butler, Pa., claiming Health and Human Services Secretary Michael Levitt is letting "anti-choice activists ... infest organizations that perform the vital task of offering women choices" (a.k.a. abortions) "regarding their reproductive health" (though many women seeking abortions are in fine health).

He refers to "this gift to the religious right" as "nothing more than an attempt by the Bush administration to inject religious zealotry into the realm of science" and suggests that this should be opposed by all physicians.

Dr. Adalja is entitled to his opinion, but there will be health professionals outside abortion clinics, making no attempt to "infest" anything, who may find themselves abruptly faced with situations where they face pressure to either facilitate an abortion or face termination, especially now that "abortion" can entail such simple but time-critical measures as RU-486 and high-dose oral contraceptives.

Regardless of whether you regard the pre-implantation and other early stages of development as human life with inalienable rights, respect that some physicians do, and choosing to respect that life in refusing to facilitate terminating it is a critical moral decision for many people. That is not "zealotry."

Facilities determined to offer 24/7 abortion services in whatever form shouldn't find ensuring adequate "pro-choice" staffing a major hurdle.

--Richard Lunsford, MD, Hopkinsville, Ky.

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Fair e-prescribing pay? Think double the primary care services rate

Regarding "Slow adoption of e-prescribing forces Medicare to try hard sell" (Article, Nov. 3): Medicare would have us all e-prescribe, but electronic prescribing either costs money or, if free, does not mesh with current electronic systems or requires time for data input. Medicare threatens to withhold payments and offers a pittance to entice the use of e-prescribing. Everyone stands to make money with our e-prescribing except us. We get to pay for it.

When are the American Medical Association, the American Academy of Family Physicians and the American College of Physicians going to stand up for us and tell Medicare that if they want us to work with them, it's time to reimburse us fairly for the work we do. A doubling of reimbursements for primary care services would be a great enticement to e-prescribe. I suspect all of us want to do it, but it's just not in the business plan at current reimbursement rates.

--John Messmer, MD, Palmyra, Pa.

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"Politics" represents the public's interest in stem cell debate

Regarding "Elections seen as turning points for stem cell studies" (Article, Oct. 20): When it comes to stem cell research, James A. Thomson, PhD, "wants politics to get out of it, finally." I struggle to understand what the scientific community means by this oft-repeated sentiment.

Do we mean that the people of the United States have no compelling interest in the conduct of scientific research? If that is the case, why should they fund us at all?

Perhaps we mean that we, as scientists, should be free from governmental oversight of professional ethics. If that is the case, would we agree that every other profession should also be free from oversight? I doubt that.

Maybe we simply look forward to a time when those who have certain moral compunctions about treating human life as a commodity no longer have a voice in the public square. If that is the case, I tremble. May we always remember that politics is people. And if we no longer value people -- their lives, beliefs, and values -- we ought to find another line of work.

--Amy Fogelstrom Chai, MD, Ellicott City, Md.

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