For Some, There Is No Choice

July 16, 2006

EMS in general has not done a lot of thinking about how to deal with moral

dilemmas that employees might have in caring for a certain patient. And

perhaps there's really no reason for it to do so.

I agree with Mike's thoughts to this extent. We have the duty to care for

our patients according to standard of care, period. When our personal beliefs

conflict with the standards we are required to carry out, then we can refuse

to carry out the function, but we do so at our legal peril. Moral standards

and legal standards are two entirely different things.

There is a melding of moral and legal standards in many aspects of criminal

law and health care law, but the bottom line is that you have a legal duty to

your patient first, and that may require that you subordinate your personal

beliefs to the requirements of your job.

There was a good article posted today on another list, which I can't

retrieve, that dealt with a situation where a patient's physicians insisted upon

a

C-section and the patient refused. The hospital was able to involve its ethics

team and negotiate a solution, which involved transporting the patient to a

different hospital, one with a higher level of care, where the patient's desires

were followed and the baby born without incident. We don't generally have

mechanisms in place in EMS to accomplish the level of sophisticated

accommodation of both employee and patient that would be required.

In Texas, we serve at the employer's pleasure unless there is a contract that

adds requirements that are different from the general law. Therefore, if

you refuse a transport on moral grounds, you may be fired summarily, and as far

as I know, there is no statutory or case law to protect an employee who simply

refuses to transport a patient for an abortion.

Perhaps it would have been better for the employer to provide another crew

member, if one were readily available, but that brings up all kinds of issues

about timely transport and lapse in patient care, which any employer would be

greatly concerned about. If there were no immediately available substitutes

then I think the employer was completely justified in firing the refusing

employee. Of course, another truck was required to be dispatched, so one could

argue that a substitute was available, but the employer should not be required

to experience chaos in coverage to accommodate the wishes of one employee.

I expect that a legal challenge to the firing will fail. Common sense tells

us that in EMS, the patient's needs are primary and our personal feelings

must sometimes be subordinated.

Suppose, for example, that an employee didn't want to care for and transport

a Jew, a Negro, an Arab, an Asian, a homosexual, an illegal alien, an HIV+

patient, or a Catholic, or a patient who was going to receive a treatment that

the employee didn't agree with, such as an abortion or a stem cell implant.

Would we allow the employee to refuse such care and transport? Of course not.

The employee would be fired without a moment's hesitation.

How, then, can one impose his or her moral values on a patient who needs the

services the EMT is employed to provide?

Further, could an EMT lose his or her certification/license for refusing to

care for and transport a patient to a facility to have a procedure done which

the certificant didn't approve of? I think so, and perhaps they should.

There are times when people need to be true to themselves and take

responsibility for their actions. If an EMS provider cannot in good conscience

care

for and carry out the transports of all patients that fall within their care,

then perhaps that person ought not be in EMS. I have not known any physicians

who wouldn't care for a certain kind of patient, even when they disagreed with

that patient's lifestyle or religious philosophy. I'm sure there are some,

but unless they can step aside and allow another physician to step in, they

are going to be liable for any injury that might occur to a patient they refused

to treat.

We all have the right to our beliefs, but not to the extent that our beliefs

harm others.

Gene G.

If we allow every religious concept to factor into our duty of care, then

dispatch will have to have a matrix of providers who are available to respond to

varying sorts of patients. DISPATCH: " Let's see, we've got a gay male AIDS

patient going to the hospice from St. Jo's. We can't sent Medic 12 because

there's a homophobe on that unit, but I think the lead medic on Medic 26 is

lesbian and might be willing to take this transfer. "

That's absurd, of course, as all of us can see. But that's where we'll be

if we allow employees to refuse to do their jobs because of personal moral

conditions.

>

> For Some, There Is No Choice

>

> By Rob Stein

> Washington Post Staff Writer

> Sunday, July 16, 2006; A06

>

> When the dispatcher called, on knew this might be the

> run she had feared. But it wasn't until her ambulance arrived at the

> hospital and she saw the words " elective abortion " on the patient's

> chart that she knew she had to make a choice.

>

> " I just got a sick feeling in my stomach, " said on, an emergency

> medical technician from Channahon, Ill.

>

> on called her boss to say she could not transport the patient to

> the other hospital where the procedure was scheduled.

>

> " I just knew I couldn't do it. I've never been for abortion -- I've

> always been against it, " on said. " I was brought up in a

> Christian home and always believed life was precious. "

>

> on's supervisor fired her on the spot and dispatched another

> ambulance to transfer the distraught young patient.

>

> " It was a very long drive home, " said on, who sued the ambulance

> company in May 2004, charging religious discrimination over her 2003

> dismissal. " I pretty much cried all the way. I was very upset and

> scared. "

>

> Many religious health workers find no conflict between their beliefs

> and their jobs. But others describe what amounts to a sense of siege,

> with the secular world increasingly demanding they capitulate to doing

> procedures, prescribing pills or performing tasks that they find

> morally reprehensible.

>

> Beginning in medical and nursing schools, some health workers describe

> struggling over where to draw the line. Will they refuse to perform an

> abortion or a sterilization, to fill a prescription for a

> morning-after pill or to pull the plug on a terminally ill patient?

> Will they refer patients to health workers who will? Or is that

> tantamount to being complicit in an immoral act?

>

> Many will discuss their experiences only with a promise of anonymity,

> fearing being reprimanded, fined, denied promotions or fired. Often

> they will speak publicly only when they have new jobs.

>

> " I've run into major conflicts with my colleagues who don't understand

> my belief system, " said Jan R. Hemstad, a Catholic anesthesiologist in

> Yakima, Wash., who will not participate in sterilizations. " I've had a

> colleague threaten to call the police to say I've abandoned a patient

> who wanted an elective sterilization.

>

> Ultrasound technician Grant of New Richmond, Wis., was fired by

> a Minneapolis clinic in 2002 after he prayed with a patient to try to

> persuade her not to get an abortion.

>

> " I'm not a rabid pro-lifer, but I know what I believe, " said Grant,

> also a pastor at a small Pentecostal church. " I was not condemning in

> any way. But I had no choice but to speak my conscience. "

>

> Pharmacist Gene Herr was fired by a drugstore in Denton, Tex., in 2004

> after refusing to fill a rape victim's prescription for the

> morning-after pill.

>

> " This was the worst-case scenario, " Herr said. " This was the hardest

> decision I ever made. The heinousness of a rape is a horrible thing.

> But I don't think you should punish a child for the sins of the

> father. "

>

> Fertility specialist D. Madden, a Catholic, will treat only

> married couples using their own sperm and eggs.

>

> " I believe the optimal circumstances for a child is to have a mother

> and a father. They contribute different things to the offspring, " said

> Madden, of the Presbyterian Hospital in Dallas. " I've sort of picked

> my way through these ethical issues my whole life, and that's one I

> haven't gotten comfortable with. "

>

> Pullicino, a Catholic neurologist from Newark, has never

> agreed to withhold patients' food and fluids.

>

> " I've had many occasions where relatives of stroke victims come up to

> me and say, 'She's suffering and wouldn't want to live in this state,

> and we want to withdraw all care,' " Pullicino said. " I've had to tell

> them, 'You'll have to find someone else.' I couldn't sleep at night if

> I did some of those things. "

>

> He also refuses to work with embryonic stem cells. " I believe it's

> destruction of a human life. It's wrong. "

>

> Family practitioners and obstetrician- Family practitioners and obs

> from town to town and being shunned by colleagues because they do not

> want to dispense birth control or morning-after pills or perform

> sterilizations or abortions. Nurses and physician assistants refuse to

> dispense the morning-after pill. Some doctors risk the ire of

> unmarried men after refusing to prescribe them Viagra.

>

> " I am convinced that God made human beings for man-to-woman marriage,

> and that is where the sexual relationship should be, " said an

> evangelical Christian who works as an internist in Baltimore. " I will

> not help foster that relationship outside of marriage. "

>

> ************ ******** ******** ******** ******** ****

>

> Since when do EMT's and Paramedics think they can decide who gets

> service and who doesn't? Would this EMT refuse to provide care for a

> doctor who performs abortions that was involved in a car accident?

>

> Regardless of my personal stance, religious stance, moral stance,

> whatever stance - on abortion - when I stepped up and accepted a patch

> and got on an ambulance, I agreed to provide care to whomever needs

> it. I support this manager firing this employee for refusing a call.

>

> Mike :/

>

July 16, 2006

I understand what you're saying. However, the court will look at the

overall picture and decide what the impact of a decision that allows an

individual

EMS certificant to pick and choose the patients he or she will care for might

be. I suspect that the court will find that to allow an employee to dictate

which calls she will respond to would impose an unreasonable constraint upon

the employer.

The federal law that you are talking about is not about emergency services.

So there are factual differences in the cases.

The anti-discrimination laws almost always bend to the requirements of the

moment: meaning that when time doesn't allow for referral to ethics committees

and sober and quiet deliberation over the consequences of an employee's

refusal to act, the employer's determination to fire an employee will almost

always

be upheld.

And, in my opinion, that is as it should be. Put yourself in the place of

the employer. You dispatch Medic 2 to take a transfer of a patient to another

hospital where there's going to be a therapeutic abortion done. Medic 2

refuses to take the call. What does this do to your system? Is it reasonable

for Medic 2 to refuse? I think not.

Would you hire an employee who tells you up front that he or she will take

all except certain categories of calls? Of course not. Are you allowed to

refuse employment to such people? Absolutely.

So this whole question is absurd.

And what about " sincerely-held religious beliefs? " What if I sincerely

believe in sacrifices of the first born son? You see, there's no way to

validate

" sincerely - held religious beliefs. "

I could say that I have a sincerely held belief that non-caucasians are

satanic individuals, and that I therefore cannot be involved in their care. If

I

could simply swear that this was my " sincerely held belief " then I could

refuse to care for anybody that didn't fit my notion of a " person. "

That won't ever happen.

Gene G.

>

> In this case, an employer fired an employee for acting in accordance with

> her religious beliefs by refusing to become a participant in an abortion.

> Under federal employment discrimination laws, employers cannot simply

> terminate an employee who objects to participating in a medical procedure

> that is contrary to the employeeâ€™s religious beliefs.

> If other arrangements were made to transport this patient to an abortion

> clinic, and the patient was not harmed as a result of the change in

> arrangements, then how can the employer justify the termination? No one

> should be punished for exercising their sincerely-held religious beliefs.

>

> Just my opinion. Case was filed over two years ago, will be interesting to

> hear the outcome.

>

> For Some, There Is No Choice

>

> > For Some, There Is No Choice

> >

> > By Rob Stein

> > Washington Post Staff Writer

> > Sunday, July 16, 2006; A06

> >

> > When the dispatcher called, on knew this might be the

> > run she had feared. But it wasn't until her ambulance arrived at the

> > hospital and she saw the words " elective abortion " on the patient's

> > chart that she knew she had to make a choice.

> >

> > " I just got a sick feeling in my stomach, " said on, an emergency

> > medical technician from Channahon, Ill.

> >

> > on called her boss to say she could not transport the patient to

> > the other hospital where the procedure was scheduled.

> >

> > " I just knew I couldn't do it. I've never been for abortion -- I've

> > always been against it, " on said. " I was brought up in a

> > Christian home and always believed life was precious. "

> >

> > on's supervisor fired her on the spot and dispatched another

> > ambulance to transfer the distraught young patient.

> >

> > " It was a very long drive home, " said on, who sued the ambulance

> > company in May 2004, charging religious discrimination over her 2003

> > dismissal. " I pretty much cried all the way. I was very upset and

> > scared. "

> >

> > Many religious health workers find no conflict between their beliefs

> > and their jobs. But others describe what amounts to a sense of siege,

> > with the secular world increasingly demanding they capitulate to doing

> > procedures, prescribing pills or performing tasks that they find

> > morally reprehensible.

> >

> > Beginning in medical and nursing schools, some health workers describe

> > struggling over where to draw the line. Will they refuse to perform an

> > abortion or a sterilization, to fill a prescription for a

> > morning-after pill or to pull the plug on a terminally ill patient?

> > Will they refer patients to health workers who will? Or is that

> > tantamount to being complicit in an immoral act?

> >

> > Many will discuss their experiences only with a promise of anonymity,

> > fearing being reprimanded, fined, denied promotions or fired. Often

> > they will speak publicly only when they have new jobs.

> >

> > " I've run into major conflicts with my colleagues who don't understand

> > my belief system, " said Jan R. Hemstad, a Catholic anesthesiologist in

> > Yakima, Wash., who will not participate in sterilizations. " I've had a

> > colleague threaten to call the police to say I've abandoned a patient

> > who wanted an elective sterilization.

> >

> > Ultrasound technician Grant of New Richmond, Wis., was fired by

> > a Minneapolis clinic in 2002 after he prayed with a patient to try to

> > persuade her not to get an abortion.

> >

> > " I'm not a rabid pro-lifer, but I know what I believe, " said Grant,

> > also a pastor at a small Pentecostal church. " I was not condemning in

> > any way. But I had no choice but to speak my conscience. "

> >

> > Pharmacist Gene Herr was fired by a drugstore in Denton, Tex., in 2004

> > after refusing to fill a rape victim's prescription for the

> > morning-after pill.

> >

> > " This was the worst-case scenario, " Herr said. " This was the hardest

> > decision I ever made. The heinousness of a rape is a horrible thing.

> > But I don't think you should punish a child for the sins of the

> > father. "

> >

> > Fertility specialist D. Madden, a Catholic, will treat only

> > married couples using their own sperm and eggs.

> >

> > " I believe the optimal circumstances for a child is to have a mother

> > and a father. They contribute different things to the offspring, " said

> > Madden, of the Presbyterian Hospital in Dallas. " I've sort of picked

> > my way through these ethical issues my whole life, and that's one I

> > haven't gotten comfortable with. "

> >

> > Pullicino, a Catholic neurologist from Newark, has never

> > agreed to withhold patients' food and fluids.

> >

> > " I've had many occasions where relatives of stroke victims come up to

> > me and say, 'She's suffering and wouldn't want to live in this state,

> > and we want to withdraw all care,' " Pullicino said. " I've had to tell

> > them, 'You'll have to find someone else.' I couldn't sleep at night if

> > I did some of those things. "

> >

> > He also refuses to work with embryonic stem cells. " I believe it's

> > destruction of a human life. It's wrong. "

> >

> > Family practitioners and obstetrician- Family practitioners and obs

> > from town to town and being shunned by colleagues because they do not

> > want to dispense birth control or morning-after pills or perform

> > sterilizations or abortions. Nurses and physician assistants refuse to

> > dispense the morning-after pill. Some doctors risk the ire of

> > unmarried men after refusing to prescribe them Viagra.

> >

> > " I am convinced that God made human beings for man-to-woman marriage,

> > and that is where the sexual relationship should be, " said an

> > evangelical Christian who works as an internist in Baltimore. " I will

> > not help foster that relationship outside of marriage. "

> >

> > ************ ******** ******** ******** ******** ****

> >

> > Since when do EMT's and Paramedics think they can decide who gets

> > service and who doesn't? Would this EMT refuse to provide care for a

> > doctor who performs abortions that was involved in a car accident?

> >

> > Regardless of my personal stance, religious stance, moral stance,

> > whatever stance - on abortion - when I stepped up and accepted a patch

> > and got on an ambulance, I agreed to provide care to whomever needs

> > it. I support this manager firing this employee for refusing a call.

> >

> > Mike :/

> >

July 16, 2006

Excellent questions!

I suppose the definition of " emergency services " has to do with what services

were available in the system. You mention taxis. In fact, this patient

may well have been able to have gone by taxi to the other facility. But the

" system " provided that she would be provided an ambulance. So it's what the

system is that describes the response.

Now, as to whether or not the physician can refuse to perform an abortion.

Yes, he or she can refuse unless it's an emergency situation where the

patient's outcome would be affected. But in an emergency situation, he or she

had

better act for the patient's best interests or be held liable for injury and

damages.

You ask what the role of the EMS is, taxi driver or something else. That,

in my judgment, depends upon what the public's expectation of the system is.

We tend to promote ourselves to the public as being the people you call when

you have any sort of a medical problem, emergency or not.

We could just as well promote ourselves as being for nothing but the most

serious cases, and we could promote taxis as alternatives to ambulance

transport,

but we don't.

EMS promotes itself as the service that you call when you have a medical

problem. We define an emergency as being in the mind of the person who is

calling, not in our minds. So we have created a system that we tell folks to

rely

upon as being the solution to their medical problems. It's all about

reliance. Once we give the populace the notion that EMS is the service to

call, and

that they can rely upon it, then we're hooked in to the duty to provide the

services we have promoted ourselves to provide.

We can provide social services at any level we want to, but we have to

conform to the expectations that we have led our clients to have of us. We

have

made EMS the people to call when you have a problem, and until we change that

per

ception, we're stuck with what we have.

Gene G.

>

> I understand your point, and respect it. Though, I would like to examine the

> definition of " emergency services. " I hardly classify a transport to an

> abortion clinic for an elective abortion as an emergency. I admit that I do

not

> know all of the facts of this case, but I am having a hard time understanding

> why an ambulance would be used for this purpose. Maybe someone can shed some

> light on this for me.

>

> I agree with your earlier assessment of the status of EMS in relation to

> this case.

>

> Let me pose this one to the group:

> A physician can refuse to perform an elective abortion without any

> retribution.

>

> A taxi driver can refuse to take a person to an abortion clinic for an

> elective abortion, and he will most likely be terminated.

>

> Which one is more similar to EMS?

> What category are we closer aligned with, physician or taxi driver?

>

> This brings me back to the question, what was the " emergency service "

> associated with taking someone to an abortion clinic for an elective

procedure?

>

> Respectfully, and admittedly not a lawyer, just asking questions...

>

> For Some, There Is No Choice

>

> > For Some, There Is No Choice

> >

> > By Rob Stein

> > Washington Post Staff Writer

> > Sunday, July 16, 2006; A06

> >

> > When the dispatcher called, on knew this might be the

> > run she had feared. But it wasn't until her ambulance arrived at the

> > hospital and she saw the words " elective abortion " on the patient's

> > chart that she knew she had to make a choice.

> >

> > " I just got a sick feeling in my stomach, " said on, an emergency

> > medical technician from Channahon, Ill.

> >

> > on called her boss to say she could not transport the patient to

> > the other hospital where the procedure was scheduled.

> >

> > " I just knew I couldn't do it. I've never been for abortion -- I've

> > always been against it, " on said. " I was brought up in a

> > Christian home and always believed life was precious. "

> >

> > on's supervisor fired her on the spot and dispatched another

> > ambulance to transfer the distraught young patient.

> >

> > " It was a very long drive home, " said on, who sued the ambulance

> > company in May 2004, charging religious discrimination over her 2003

> > dismissal. " I pretty much cried all the way. I was very upset and

> > scared. "

> >

> > Many religious health workers find no conflict between their beliefs

> > and their jobs. But others describe what amounts to a sense of siege,

> > with the secular world increasingly demanding they capitulate to doing

> > procedures, prescribing pills or performing tasks that they find

> > morally reprehensible.

> >

> > Beginning in medical and nursing schools, some health workers describe

> > struggling over where to draw the line. Will they refuse to perform an

> > abortion or a sterilization, to fill a prescription for a

> > morning-after pill or to pull the plug on a terminally ill patient?

> > Will they refer patients to health workers who will? Or is that

> > tantamount to being complicit in an immoral act?

> >

> > Many will discuss their experiences only with a promise of anonymity,

> > fearing being reprimanded, fined, denied promotions or fired. Often

> > they will speak publicly only when they have new jobs.

> >

> > " I've run into major conflicts with my colleagues who don't understand

> > my belief system, " said Jan R. Hemstad, a Catholic anesthesiologist in

> > Yakima, Wash., who will not participate in sterilizations. " I've had a

> > colleague threaten to call the police to say I've abandoned a patient

> > who wanted an elective sterilization.

> >

> > Ultrasound technician Grant of New Richmond, Wis., was fired by

> > a Minneapolis clinic in 2002 after he prayed with a patient to try to

> > persuade her not to get an abortion.

> >

> > " I'm not a rabid pro-lifer, but I know what I believe, " said Grant,

> > also a pastor at a small Pentecostal church. " I was not condemning in

> > any way. But I had no choice but to speak my conscience. "

> >

> > Pharmacist Gene Herr was fired by a drugstore in Denton, Tex., in 2004

> > after refusing to fill a rape victim's prescription for the

> > morning-after pill.

> >

> > " This was the worst-case scenario, " Herr said. " This was the hardest

> > decision I ever made. The heinousness of a rape is a horrible thing.

> > But I don't think you should punish a child for the sins of the

> > father. "

> >

> > Fertility specialist D. Madden, a Catholic, will treat only

> > married couples using their own sperm and eggs.

> >

> > " I believe the optimal circumstances for a child is to have a mother

> > and a father. They contribute different things to the offspring, " said

> > Madden, of the Presbyterian Hospital in Dallas. " I've sort of picked

> > my way through these ethical issues my whole life, and that's one I

> > haven't gotten comfortable with. "

> >

> > Pullicino, a Catholic neurologist from Newark, has never

> > agreed to withhold patients' food and fluids.

> >

> > " I've had many occasions where relatives of stroke victims come up to

> > me and say, 'She's suffering and wouldn't want to live in this state,

> > and we want to withdraw all care,' " Pullicino said. " I've had to tell

> > them, 'You'll have to find someone else.' I couldn't sleep at night if

> > I did some of those things. "

> >

> > He also refuses to work with embryonic stem cells. " I believe it's

> > destruction of a human life. It's wrong. "

> >

> > Family practitioners and obstetrician- Family practitioners and obs

> > from town to town and being shunned by colleagues because they do not

> > want to dispense birth control or morning-after pills or perform

> > sterilizations or abortions. Nurses and physician assistants refuse to

> > dispense the morning-after pill. Some doctors risk the ire of

> > unmarried men after refusing to prescribe them Viagra.

> >

> > " I am convinced that God made human beings for man-to-woman marriage,

> > and that is where the sexual relationship should be, " said an

> > evangelical Christian who works as an internist in Baltimore. " I will

> > not help foster that relationship outside of marriage. "

> >

> > ************ ******** ******** ******** ******** ****

> >

> > Since when do EMT's and Paramedics think they can decide who gets

> > service and who doesn't? Would this EMT refuse to provide care for a

> > doctor who performs abortions that was involved in a car accident?

> >

> > Regardless of my personal stance, religious stance, moral stance,

> > whatever stance - on abortion - when I stepped up and accepted a patch

> > and got on an ambulance, I agreed to provide care to whomever needs

> > it. I support this manager firing this employee for refusing a call.

> >

> > Mike :/

> >

July 16, 2006

,

Let's get it to its simplest concepts. An EMT doesn't deal with moral

questions about this or that procedure. An EMT takes the calls that are

dispatched and does them to the best of her or his ability.

So it's entirely beside the point whether or not this EMT had a problem with

the patient. When you go to work for an EMS service, you don't sign on only

to transport patients that meet your moral requirements. No employer would

hire such a person.

Whether or not it was an emergency or not, in fact, has nothing to do with

the situation at all. The question is whether or not the employee had the

legal right to refuse the transport of a patient that was going to have a

procedure that she didn't agree with. And the law is clear that the employee

has no

such right.

So it's simple. You take a job, you agree to do the job. Unless the job

requires you to commit a crime, which you're not obligated to do, then you're

required to do the job requirements. Period.

The medic in this case has no excuse for not performing, she deserved to be

fired, and her firing will be upheld by the courts if she gets that far.

Gene G.

>

> If society views pregnancy as a " medical problem " that requires an ambulance

> to transport the " patient " to the abortion clinic, then perhaps my line of

> questioning is irrelevant.

>

> Gene said... " Yes, he or she [the physician] can refuse unless it's an

> emergency situation where the patient's outcome would be affected. But in

> an emergency situation, he or she had better act for the patient's best

> interests or be held liable for injury and damages. "

>

> Help me understand this. If it is an emergency... Help me understand this

> transfer the patient to an elective abortion clinic? If this case was an

> emergency, would the elective abortion clinic be the best place to care for

> the patient? I think by virtue of the fact that " elective " abortion was the

> patient's reason for transfer rules out the " emergency. " Why is it

> different for the EMT?

>

> For Some, There Is No Choice

> >

> > > For Some, There Is No Choice

> > >

> > > By Rob Stein

> > > Washington Post Staff Writer

> > > Sunday, July 16, 2006; A06

> > >

> > > When the dispatcher called, on knew this might be the

> > > run she had feared. But it wasn't until her ambulance arrived at the

> > > hospital and she saw the words " elective abortion " on the patient's

> > > chart that she knew she had to make a choice.

> > >

> > > " I just got a sick feeling in my stomach, " said on, an emergency

> > > medical technician from Channahon, Ill.

> > >

> > > on called her boss to say she could not transport the patient to

> > > the other hospital where the procedure was scheduled.

> > >

> > > " I just knew I couldn't do it. I've never been for abortion -- I've

> > > always been against it, " on said. " I was brought up in a

> > > Christian home and always believed life was precious. "

> > >

> > > on's supervisor fired her on the spot and dispatched another

> > > ambulance to transfer the distraught young patient.

> > >

> > > " It was a very long drive home, " said on, who sued the ambulance

> > > company in May 2004, charging religious discrimination over her 2003

> > > dismissal. " I pretty much cried all the way. I was very upset and

> > > scared. "

> > >

> > > Many religious health workers find no conflict between their beliefs

> > > and their jobs. But others describe what amounts to a sense of siege,

> > > with the secular world increasingly demanding they capitulate to doing

> > > procedures, prescribing pills or performing tasks that they find

> > > morally reprehensible.

> > >

> > > Beginning in medical and nursing schools, some health workers describe

> > > struggling over where to draw the line. Will they refuse to perform an

> > > abortion or a sterilization, to fill a prescription for a

> > > morning-after pill or to pull the plug on a terminally ill patient?

> > > Will they refer patients to health workers who will? Or is that

> > > tantamount to being complicit in an immoral act?

> > >

> > > Many will discuss their experiences only with a promise of anonymity,

> > > fearing being reprimanded, fined, denied promotions or fired. Often

> > > they will speak publicly only when they have new jobs.

> > >

> > > " I've run into major conflicts with my colleagues who don't understand

> > > my belief system, " said Jan R. Hemstad, a Catholic anesthesiologist in

> > > Yakima, Wash., who will not participate in sterilizations. " I've had a

> > > colleague threaten to call the police to say I've abandoned a patient

> > > who wanted an elective sterilization.

> > >

> > > Ultrasound technician Grant of New Richmond, Wis., was fired by

> > > a Minneapolis clinic in 2002 after he prayed with a patient to try to

> > > persuade her not to get an abortion.

> > >

> > > " I'm not a rabid pro-lifer, but I know what I believe, " said Grant,

> > > also a pastor at a small Pentecostal church. " I was not condemning in

> > > any way. But I had no choice but to speak my conscience. "

> > >

> > > Pharmacist Gene Herr was fired by a drugstore in Denton, Tex., in 2004

> > > after refusing to fill a rape victim's prescription for the

> > > morning-after pill.

> > >

> > > " This was the worst-case scenario, " Herr said. " This was the hardest

> > > decision I ever made. The heinousness of a rape is a horrible thing.

> > > But I don't think you should punish a child for the sins of the

> > > father. "

> > >

> > > Fertility specialist D. Madden, a Catholic, will treat only

> > > married couples using their own sperm and eggs.

> > >

> > > " I believe the optimal circumstances for a child is to have a mother

> > > and a father. They contribute different things to the offspring, " said

> > > Madden, of the Presbyterian Hospital in Dallas. " I've sort of picked

> > > my way through these ethical issues my whole life, and that's one I

> > > haven't gotten comfortable with. "

> > >

> > > Pullicino, a Catholic neurologist from Newark, has never

> > > agreed to withhold patients' food and fluids.

> > >

> > > " I've had many occasions where relatives of stroke victims come up to

> > > me and say, 'She's suffering and wouldn't want to live in this state,

> > > and we want to withdraw all care,' " Pullicino said. " I've had to tell

> > > them, 'You'll have to find someone else.' I couldn't sleep at night if

> > > I did some of those things. "

> > >

> > > He also refuses to work with embryonic stem cells. " I believe it's

> > > destruction of a human life. It's wrong. "

> > >

> > > Family practitioners and obstetrician- Family practitioners and obs

> > > from town to town and being shunned by colleagues because they do not

> > > want to dispense birth control or morning-after pills or perform

> > > sterilizations or abortions. Nurses and physician assistants refuse to

> > > dispense the morning-after pill. Some doctors risk the ire of

> > > unmarried men after refusing to prescribe them Viagra.

> > >

> > > " I am convinced that God made human beings for man-to-woman marriage,

> > > and that is where the sexual relationship should be, " said an

> > > evangelical Christian who works as an internist in Baltimore. " I will

> > > not help foster that relationship outside of marriage. "

> > >

> > > ************ ******** ******** ******** ******** ****

> > >

> > > Since when do EMT's and Paramedics think they can decide who gets

> > > service and who doesn't? Would this EMT refuse to provide care for a

> > > doctor who performs abortions that was involved in a car accident?

> > >

> > > Regardless of my personal stance, religious stance, moral stance,

> > > whatever stance - on abortion - when I stepped up and accepted a patch

> > > and got on an ambulance, I agreed to provide care to whomever needs

> > > it. I support this manager firing this employee for refusing a call.

> > >

> > > Mike :/

> > >

July 16, 2006

Not necessarily. The physician could only refuse if his refusal would not

have caused harm to the patient. And EMS considerations and those of

physicians are quite different. Take a look at the job descriptions.

You're off base in trying to compare a physician's treatment determinations

and an EMS employee's duty to carry out the job description. They're not the

same.

Physicians are independent practitioners; EMS people are not. Physicians

are not routinely assigned to transport patients from one place to another, EMS

people are.

The EMS employee is not being asked to perform the procedure. She is only

being asked to take the patient to the place where the procedure might be

performed. The physician has the power to do the procedure or not do it. The

EMS provider's not even close in terms of job description.

Gene G.

>

> Then I guess the EMT in this case should have become a physician. Then she

> would have been allowed to follow her religious beliefs.

>

> Too bad EMTs and physicians are held to different standards regarding

> religious beliefs and their practice.

>

> >

July 16, 2006

For Some, There Is No Choice

By Rob Stein

Washington Post Staff Writer

Sunday, July 16, 2006; A06

When the dispatcher called, on knew this might be the

run she had feared. But it wasn't until her ambulance arrived at the

hospital and she saw the words " elective abortion " on the patient's

chart that she knew she had to make a choice.

" I just got a sick feeling in my stomach, " said on, an emergency

medical technician from Channahon, Ill.

on called her boss to say she could not transport the patient to

the other hospital where the procedure was scheduled.

" I just knew I couldn't do it. I've never been for abortion -- I've

always been against it, " on said. " I was brought up in a

Christian home and always believed life was precious. "

on's supervisor fired her on the spot and dispatched another

ambulance to transfer the distraught young patient.

" It was a very long drive home, " said on, who sued the ambulance

company in May 2004, charging religious discrimination over her 2003

dismissal. " I pretty much cried all the way. I was very upset and

scared. "

Many religious health workers find no conflict between their beliefs

and their jobs. But others describe what amounts to a sense of siege,

with the secular world increasingly demanding they capitulate to doing

procedures, prescribing pills or performing tasks that they find

morally reprehensible.

Beginning in medical and nursing schools, some health workers describe

struggling over where to draw the line. Will they refuse to perform an

abortion or a sterilization, to fill a prescription for a

morning-after pill or to pull the plug on a terminally ill patient?

Will they refer patients to health workers who will? Or is that

tantamount to being complicit in an immoral act?

Many will discuss their experiences only with a promise of anonymity,

fearing being reprimanded, fined, denied promotions or fired. Often

they will speak publicly only when they have new jobs.

" I've run into major conflicts with my colleagues who don't understand

my belief system, " said Jan R. Hemstad, a Catholic anesthesiologist in

Yakima, Wash., who will not participate in sterilizations. " I've had a

colleague threaten to call the police to say I've abandoned a patient

who wanted an elective sterilization. "

Ultrasound technician Grant of New Richmond, Wis., was fired by

a Minneapolis clinic in 2002 after he prayed with a patient to try to

persuade her not to get an abortion.

" I'm not a rabid pro-lifer, but I know what I believe, " said Grant,

also a pastor at a small Pentecostal church. " I was not condemning in

any way. But I had no choice but to speak my conscience. "

Pharmacist Gene Herr was fired by a drugstore in Denton, Tex., in 2004

after refusing to fill a rape victim's prescription for the

morning-after pill.

" This was the worst-case scenario, " Herr said. " This was the hardest

decision I ever made. The heinousness of a rape is a horrible thing.

But I don't think you should punish a child for the sins of the

father. "

Fertility specialist D. Madden, a Catholic, will treat only

married couples using their own sperm and eggs.

" I believe the optimal circumstances for a child is to have a mother

and a father. They contribute different things to the offspring, " said

Madden, of the Presbyterian Hospital in Dallas. " I've sort of picked

my way through these ethical issues my whole life, and that's one I

haven't gotten comfortable with. "

Pullicino, a Catholic neurologist from Newark, has never

agreed to withhold patients' food and fluids.

" I've had many occasions where relatives of stroke victims come up to

me and say, 'She's suffering and wouldn't want to live in this state,

and we want to withdraw all care,' " Pullicino said. " I've had to tell

them, 'You'll have to find someone else.' I couldn't sleep at night if

I did some of those things. "

He also refuses to work with embryonic stem cells. " I believe it's

destruction of a human life. It's wrong. "

Family practitioners and obstetrician-gynecologists describe moving

from town to town and being shunned by colleagues because they do not

want to dispense birth control or morning-after pills or perform

sterilizations or abortions. Nurses and physician assistants refuse to

dispense the morning-after pill. Some doctors risk the ire of

unmarried men after refusing to prescribe them Viagra.

" I am convinced that God made human beings for man-to-woman marriage,

and that is where the sexual relationship should be, " said an

evangelical Christian who works as an internist in Baltimore. " I will

not help foster that relationship outside of marriage. "

*****************************************************

Since when do EMT's and Paramedics think they can decide who gets

service and who doesn't? Would this EMT refuse to provide care for a

doctor who performs abortions that was involved in a car accident?

Regardless of my personal stance, religious stance, moral stance,

whatever stance - on abortion - when I stepped up and accepted a patch

and got on an ambulance, I agreed to provide care to whomever needs

it. I support this manager firing this employee for refusing a call.

Mike :/

July 16, 2006

As a physician, these are always tough calls:

The Hippocratic Oath

(Original Version)

I SWEAR by Apollo the physician, Ç¼sculapius, and Health, and All-heal, and all

the gods and goddesses, that, according to my ability and judgment, I will keep

this Oath and this stipulation.

TO RECHON him who taught me this Art equally dear to me as my parents, to share

my substance with him, and relieve his necessities if required; to look up his

offspring in the same footing as my own brothers, and to teach them this art, if

they shall wish to learn it, without fee or stipulation; and that by precept,

lecture, and every other mode of instruction, I will impart a knowledge of the

Art to my own sons, and those of my teachers, and to disciples bound by a

stipulation and oath according the law of medicine, but to none others.

I WILL FOLLOW that system of regimen which, according to my ability and

judgment, I consider for the benefit of my patients, and abstain from whatever

is deleterious and mischievous. I will give no deadly medicine to any one if

asked, nor suggest any such counsel; and in like manner I will not give a woman

a pessary to produce abortion.

WITH PURITY AND WITH HOLINESS I will pass my life and practice my Art. I will

not cut persons laboring under the stone, but will leave this to be done by men

who are practitioners of this work. Into whatever houses I enter, I will go into

them for the benefit of the sick, and will abstain from every voluntary act of

mischief and corruption; and, further from the seduction of females or males, of

freemen and slaves.

WHATEVER, IN CONNECTION with my professional practice or not, in connection with

it, I see or hear, in the life of men, which ought not to be spoken of abroad, I

will not divulge, as reckoning that all such should be kept secret.

WHILE I CONTINUE to keep this Oath unviolated, may it be granted to me to enjoy

life and the practice of the art, respected by all men, in all times! But should

I trespass and violate this Oath, may the reverse be my lot!

------------------------------------------

THE OSTEOPATHIC OATH

I do hereby affirm my loyalty to the profession I am about to enter.

I will be mindful always of my great responsibility to preserve the health and

life of my patients, to retain their confidence and respect both as a physician

and a friend who will guard their secrets with scrupulous honor and fidelity, to

perform faithfully my professional duties, to employ only those recognized

methods of treatment consistent with good judgment and with my skill and

ability, keeping in mind always natureâ€™s laws and the bodyâ€™s inherent

capacity for recovery.

I will be ever vigilant in aiding in the general welfare of the community,

sustaining its laws and institutions, not engaging in those practices which will

in any way bring shame or discredit upon myself or my profession.

I will give no drugs for deadly purposes to any person, though it be asked of

me.

I will endeavor to work in accord with my colleagues in a spirit of progressive

cooperation and never by word or by act cast imputations upon them or their

rightful practices.

I will look with respect and esteem upon all those who have taught me my art. To

my college I will be loyal and strive always for its best interests and for the

interests of the students who will come after me.

I will be ever alert to further the application of basic biologic truths to the

healing arts and to develop the principles of osteopathy which were first

enunciated by Still.

________________________________________

From: texasems-l [mailto:texasems-l ] On Behalf

Of Mike

Sent: Sunday, July 16, 2006 11:18 PM

To: TexasEMS-L; Paramedicine

Subject: For Some, There Is No Choice

For Some, There Is No Choice

By Rob Stein

Washington Post Staff Writer

Sunday, July 16, 2006; A06

When the dispatcher called, on knew this might be the

run she had feared. But it wasn't until her ambulance arrived at the

hospital and she saw the words " elective abortion " on the patient's

chart that she knew she had to make a choice.

" I just got a sick feeling in my stomach, " said on, an emergency

medical technician from Channahon, Ill.

on called her boss to say she could not transport the patient to

the other hospital where the procedure was scheduled.

" I just knew I couldn't do it. I've never been for abortion -- I've

always been against it, " on said. " I was brought up in a

Christian home and always believed life was precious. "

on's supervisor fired her on the spot and dispatched another

ambulance to transfer the distraught young patient.

" It was a very long drive home, " said on, who sued the ambulance

company in May 2004, charging religious discrimination over her 2003

dismissal. " I pretty much cried all the way. I was very upset and

scared. "

Many religious health workers find no conflict between their beliefs

and their jobs. But others describe what amounts to a sense of siege,

with the secular world increasingly demanding they capitulate to doing

procedures, prescribing pills or performing tasks that they find

morally reprehensible.

Beginning in medical and nursing schools, some health workers describe

struggling over where to draw the line. Will they refuse to perform an

abortion or a sterilization, to fill a prescription for a

morning-after pill or to pull the plug on a terminally ill patient?

Will they refer patients to health workers who will? Or is that

tantamount to being complicit in an immoral act?

Many will discuss their experiences only with a promise of anonymity,

fearing being reprimanded, fined, denied promotions or fired. Often

they will speak publicly only when they have new jobs.

" I've run into major conflicts with my colleagues who don't understand

my belief system, " said Jan R. Hemstad, a Catholic anesthesiologist in

Yakima, Wash., who will not participate in sterilizations. " I've had a

colleague threaten to call the police to say I've abandoned a patient

who wanted an elective sterilization. "

Ultrasound technician Grant of New Richmond, Wis., was fired by

a Minneapolis clinic in 2002 after he prayed with a patient to try to

persuade her not to get an abortion.

" I'm not a rabid pro-lifer, but I know what I believe, " said Grant,

also a pastor at a small Pentecostal church. " I was not condemning in

any way. But I had no choice but to speak my conscience. "

Pharmacist Gene Herr was fired by a drugstore in Denton, Tex., in 2004

after refusing to fill a rape victim's prescription for the

morning-after pill.

" This was the worst-case scenario, " Herr said. " This was the hardest

decision I ever made. The heinousness of a rape is a horrible thing.

But I don't think you should punish a child for the sins of the

father. "

Fertility specialist D. Madden, a Catholic, will treat only

married couples using their own sperm and eggs.

" I believe the optimal circumstances for a child is to have a mother

and a father. They contribute different things to the offspring, " said

Madden, of the Presbyterian Hospital in Dallas. " I've sort of picked

my way through these ethical issues my whole life, and that's one I

haven't gotten comfortable with. "

Pullicino, a Catholic neurologist from Newark, has never

agreed to withhold patients' food and fluids.

" I've had many occasions where relatives of stroke victims come up to

me and say, 'She's suffering and wouldn't want to live in this state,

and we want to withdraw all care,' " Pullicino said. " I've had to tell

them, 'You'll have to find someone else.' I couldn't sleep at night if

I did some of those things. "

He also refuses to work with embryonic stem cells. " I believe it's

destruction of a human life. It's wrong. "

Family practitioners and obstetrician-gynecologists describe moving

from town to town and being shunned by colleagues because they do not

want to dispense birth control or morning-after pills or perform

sterilizations or abortions. Nurses and physician assistants refuse to

dispense the morning-after pill. Some doctors risk the ire of

unmarried men after refusing to prescribe them Viagra.

" I am convinced that God made human beings for man-to-woman marriage,

and that is where the sexual relationship should be, " said an

evangelical Christian who works as an internist in Baltimore. " I will

not help foster that relationship outside of marriage. "

*****************************************************

Since when do EMT's and Paramedics think they can decide who gets

service and who doesn't? Would this EMT refuse to provide care for a

doctor who performs abortions that was involved in a car accident?

Regardless of my personal stance, religious stance, moral stance,

whatever stance - on abortion - when I stepped up and accepted a patch

and got on an ambulance, I agreed to provide care to whomever needs

it. I support this manager firing this employee for refusing a call.

Mike :/

July 16, 2006

In this case, an employer fired an employee for acting in accordance with

her religious beliefs by refusing to become a participant in an abortion.

Under federal employment discrimination laws, employers cannot simply

terminate an employee who objects to participating in a medical procedure

that is contrary to the employeeâ€™s religious beliefs.

If other arrangements were made to transport this patient to an abortion

clinic, and the patient was not harmed as a result of the change in

arrangements, then how can the employer justify the termination? No one

should be punished for exercising their sincerely-held religious beliefs.

Just my opinion. Case was filed over two years ago, will be interesting to

hear the outcome.

For Some, There Is No Choice

> For Some, There Is No Choice

>

> By Rob Stein

> Washington Post Staff Writer

> Sunday, July 16, 2006; A06

>

> When the dispatcher called, on knew this might be the

> run she had feared. But it wasn't until her ambulance arrived at the

> hospital and she saw the words " elective abortion " on the patient's

> chart that she knew she had to make a choice.

>

> " I just got a sick feeling in my stomach, " said on, an emergency

> medical technician from Channahon, Ill.

>

> on called her boss to say she could not transport the patient to

> the other hospital where the procedure was scheduled.

>

> " I just knew I couldn't do it. I've never been for abortion -- I've

> always been against it, " on said. " I was brought up in a

> Christian home and always believed life was precious. "

>

> on's supervisor fired her on the spot and dispatched another

> ambulance to transfer the distraught young patient.

>

> " It was a very long drive home, " said on, who sued the ambulance

> company in May 2004, charging religious discrimination over her 2003

> dismissal. " I pretty much cried all the way. I was very upset and

> scared. "

>

> Many religious health workers find no conflict between their beliefs

> and their jobs. But others describe what amounts to a sense of siege,

> with the secular world increasingly demanding they capitulate to doing

> procedures, prescribing pills or performing tasks that they find

> morally reprehensible.

>

> Beginning in medical and nursing schools, some health workers describe

> struggling over where to draw the line. Will they refuse to perform an

> abortion or a sterilization, to fill a prescription for a

> morning-after pill or to pull the plug on a terminally ill patient?

> Will they refer patients to health workers who will? Or is that

> tantamount to being complicit in an immoral act?

>

> Many will discuss their experiences only with a promise of anonymity,

> fearing being reprimanded, fined, denied promotions or fired. Often

> they will speak publicly only when they have new jobs.

>

> " I've run into major conflicts with my colleagues who don't understand

> my belief system, " said Jan R. Hemstad, a Catholic anesthesiologist in

> Yakima, Wash., who will not participate in sterilizations. " I've had a

> colleague threaten to call the police to say I've abandoned a patient

> who wanted an elective sterilization. "

>

> Ultrasound technician Grant of New Richmond, Wis., was fired by

> a Minneapolis clinic in 2002 after he prayed with a patient to try to

> persuade her not to get an abortion.

>

> " I'm not a rabid pro-lifer, but I know what I believe, " said Grant,

> also a pastor at a small Pentecostal church. " I was not condemning in

> any way. But I had no choice but to speak my conscience. "

>

> Pharmacist Gene Herr was fired by a drugstore in Denton, Tex., in 2004

> after refusing to fill a rape victim's prescription for the

> morning-after pill.

>

> " This was the worst-case scenario, " Herr said. " This was the hardest

> decision I ever made. The heinousness of a rape is a horrible thing.

> But I don't think you should punish a child for the sins of the

> father. "

>

> Fertility specialist D. Madden, a Catholic, will treat only

> married couples using their own sperm and eggs.

>

> " I believe the optimal circumstances for a child is to have a mother

> and a father. They contribute different things to the offspring, " said

> Madden, of the Presbyterian Hospital in Dallas. " I've sort of picked

> my way through these ethical issues my whole life, and that's one I

> haven't gotten comfortable with. "

>

> Pullicino, a Catholic neurologist from Newark, has never

> agreed to withhold patients' food and fluids.

>

> " I've had many occasions where relatives of stroke victims come up to

> me and say, 'She's suffering and wouldn't want to live in this state,

> and we want to withdraw all care,' " Pullicino said. " I've had to tell

> them, 'You'll have to find someone else.' I couldn't sleep at night if

> I did some of those things. "

>

> He also refuses to work with embryonic stem cells. " I believe it's

> destruction of a human life. It's wrong. "

>

> Family practitioners and obstetrician-gynecologists describe moving

> from town to town and being shunned by colleagues because they do not

> want to dispense birth control or morning-after pills or perform

> sterilizations or abortions. Nurses and physician assistants refuse to

> dispense the morning-after pill. Some doctors risk the ire of

> unmarried men after refusing to prescribe them Viagra.

>

> " I am convinced that God made human beings for man-to-woman marriage,

> and that is where the sexual relationship should be, " said an

> evangelical Christian who works as an internist in Baltimore. " I will

> not help foster that relationship outside of marriage. "

>

> *****************************************************

>

> Since when do EMT's and Paramedics think they can decide who gets

> service and who doesn't? Would this EMT refuse to provide care for a

> doctor who performs abortions that was involved in a car accident?

>

> Regardless of my personal stance, religious stance, moral stance,

> whatever stance - on abortion - when I stepped up and accepted a patch

> and got on an ambulance, I agreed to provide care to whomever needs

> it. I support this manager firing this employee for refusing a call.

>

> Mike :/

>

July 17, 2006

>

> In this case, an employer fired an employee for acting in accordance with

> her religious beliefs by refusing to become a participant in an abortion.

No, let's be clear. She was fired for refusing to transport a patient

that the service had agreed to take. Had she been acting in her

religious beliefs, she would either have not accepted the patch in the

first place because she should have known she would have to interact

with people and treat them in ways that she would find herself unable

to do, religiously, or she should have informed her employer that she

was not willing to perform for them on 100% of their calls for

service.

> Under federal employment discrimination laws, employers cannot simply

> terminate an employee who objects to participating in a medical procedure

> that is contrary to the employee's religious beliefs.

Correct, but you can fire them for refusing to do their job. She

wasn't directly performing any service related to an abortion - she

was transferring the patient to a facility full of medial providers

who were able to provide the service per the patient's wishes, which

were likely inline with the patient's moral, ethical and religious

beliefs. Bottom line? She accepted a job knowing that this could

come up, and when it did, she refused to do her job. Her employer

can, and should, fire her for that.

> If other arrangements were made to transport this patient to an abortion

> clinic, and the patient was not harmed as a result of the change in

> arrangements, then how can the employer justify the termination? No one

> should be punished for exercising their sincerely-held religious beliefs.

Insubordination comes as a primary justification. And anyone who

accepts a job in which their beliefs could be compromised, then

complains when they choose to abandon the responsibilities of the job

they accepted and agreed to do can and should be punished.

You want to hold tight to your religious beliefs to the point that you

refuse to provide care for someone? Fine. Don't work in EMS.

Mike

July 17, 2006

I understand your point, and respect it. Though, I would like to examine the

definition of " emergency services. " I hardly classify a transport to an

abortion clinic for an elective abortion as an emergency. I admit that I do not

know all of the facts of this case, but I am having a hard time understanding

why an ambulance would be used for this purpose. Maybe someone can shed some

light on this for me.

I agree with your earlier assessment of the status of EMS in relation to this

case.

Let me pose this one to the group:

A physician can refuse to perform an elective abortion without any retribution.

A taxi driver can refuse to take a person to an abortion clinic for an elective

abortion, and he will most likely be terminated.

Which one is more similar to EMS?

What category are we closer aligned with, physician or taxi driver?

This brings me back to the question, what was the " emergency service " associated

with taking someone to an abortion clinic for an elective procedure?

Respectfully, and admittedly not a lawyer, just asking questions....

For Some, There Is No Choice

> For Some, There Is No Choice

>

> By Rob Stein

> Washington Post Staff Writer

> Sunday, July 16, 2006; A06

>

> When the dispatcher called, on knew this might be the

> run she had feared. But it wasn't until her ambulance arrived at the

> hospital and she saw the words " elective abortion " on the patient's

> chart that she knew she had to make a choice.

>

> " I just got a sick feeling in my stomach, " said on, an emergency

> medical technician from Channahon, Ill.

>

> on called her boss to say she could not transport the patient to

> the other hospital where the procedure was scheduled.

>

> " I just knew I couldn't do it. I've never been for abortion -- I've

> always been against it, " on said. " I was brought up in a

> Christian home and always believed life was precious. "

>

> on's supervisor fired her on the spot and dispatched another

> ambulance to transfer the distraught young patient.

>

> " It was a very long drive home, " said on, who sued the ambulance

> company in May 2004, charging religious discrimination over her 2003

> dismissal. " I pretty much cried all the way. I was very upset and

> scared. "

>

> Many religious health workers find no conflict between their beliefs

> and their jobs. But others describe what amounts to a sense of siege,

> with the secular world increasingly demanding they capitulate to doing

> procedures, prescribing pills or performing tasks that they find

> morally reprehensible.

>

> Beginning in medical and nursing schools, some health workers describe

> struggling over where to draw the line. Will they refuse to perform an

> abortion or a sterilization, to fill a prescription for a

> morning-after pill or to pull the plug on a terminally ill patient?

> Will they refer patients to health workers who will? Or is that

> tantamount to being complicit in an immoral act?

>

> Many will discuss their experiences only with a promise of anonymity,

> fearing being reprimanded, fined, denied promotions or fired. Often

> they will speak publicly only when they have new jobs.

>

> " I've run into major conflicts with my colleagues who don't understand

> my belief system, " said Jan R. Hemstad, a Catholic anesthesiologist in

> Yakima, Wash., who will not participate in sterilizations. " I've had a

> colleague threaten to call the police to say I've abandoned a patient

> who wanted an elective sterilization.

>

> Ultrasound technician Grant of New Richmond, Wis., was fired by

> a Minneapolis clinic in 2002 after he prayed with a patient to try to

> persuade her not to get an abortion.

>

> " I'm not a rabid pro-lifer, but I know what I believe, " said Grant,

> also a pastor at a small Pentecostal church. " I was not condemning in

> any way. But I had no choice but to speak my conscience. "

>

> Pharmacist Gene Herr was fired by a drugstore in Denton, Tex., in 2004

> after refusing to fill a rape victim's prescription for the

> morning-after pill.

>

> " This was the worst-case scenario, " Herr said. " This was the hardest

> decision I ever made. The heinousness of a rape is a horrible thing.

> But I don't think you should punish a child for the sins of the

> father. "

>

> Fertility specialist D. Madden, a Catholic, will treat only

> married couples using their own sperm and eggs.

>

> " I believe the optimal circumstances for a child is to have a mother

> and a father. They contribute different things to the offspring, " said

> Madden, of the Presbyterian Hospital in Dallas. " I've sort of picked

> my way through these ethical issues my whole life, and that's one I

> haven't gotten comfortable with. "

>

> Pullicino, a Catholic neurologist from Newark, has never

> agreed to withhold patients' food and fluids.

>

> " I've had many occasions where relatives of stroke victims come up to

> me and say, 'She's suffering and wouldn't want to live in this state,

> and we want to withdraw all care,' " Pullicino said. " I've had to tell

> them, 'You'll have to find someone else.' I couldn't sleep at night if

> I did some of those things. "

>

> He also refuses to work with embryonic stem cells. " I believe it's

> destruction of a human life. It's wrong. "

>

> Family practitioners and obstetrician- Family practitioners and obs

> from town to town and being shunned by colleagues because they do not

> want to dispense birth control or morning-after pills or perform

> sterilizations or abortions. Nurses and physician assistants refuse to

> dispense the morning-after pill. Some doctors risk the ire of

> unmarried men after refusing to prescribe them Viagra.

>

> " I am convinced that God made human beings for man-to-woman marriage,

> and that is where the sexual relationship should be, " said an

> evangelical Christian who works as an internist in Baltimore. " I will

> not help foster that relationship outside of marriage. "

>

> ************ ******** ******** ******** ******** ****

>

> Since when do EMT's and Paramedics think they can decide who gets

> service and who doesn't? Would this EMT refuse to provide care for a

> doctor who performs abortions that was involved in a car accident?

>

> Regardless of my personal stance, religious stance, moral stance,

> whatever stance - on abortion - when I stepped up and accepted a patch

> and got on an ambulance, I agreed to provide care to whomever needs

> it. I support this manager firing this employee for refusing a call.

>

> Mike :/

>

July 17, 2006

How on earth can someone say, we're not going to transport you

because your beliefs or choices are not the beliefs or choices we

would make? That is almost as frustrating as running into someone

who refuses to allow their severely injured child a blood

transfusion that would save their life because they don't believe in

blood transfusions or allowing a procedure to be done that would

save their life because they don't believe in it.

I've been put in numberous moral/etihical delemias here since I've

deployed. Some I could live with, some I could not. I can honestly

say I have made decisions that I could live with. My guide is

remembering that I took an oath to do no harm.

Do I have my religious beliefs? Yes. Will some of these beliefs make

my life as a PA challanging? Yes. I know we are not suppose to

play " God " however there are certain situations in which I don't

know if I could bring my self to assist in an abortion and there are

others where I think it should be an option. HOWEVER, I hate it

when people force their beliefs religious or otherwise down my

throat and I refuse to do that to other people. It's their decision

and they have to live with it. So although as far as being a

paramedic I have made up my mind. As my education progresses I will

have to make some difficult decisions.

Anyhow, That's my two cents worth.

>

> I understand what you're saying. However, the court will look at

the

> overall picture and decide what the impact of a decision that

allows an individual

> EMS certificant to pick and choose the patients he or she will

care for might

> be. I suspect that the court will find that to allow an employee

to dictate

> which calls she will respond to would impose an unreasonable

constraint upon

> the employer.

>

> The federal law that you are talking about is not about emergency

services.

> So there are factual differences in the cases.

>

> The anti-discrimination laws almost always bend to the

requirements of the

> moment: meaning that when time doesn't allow for referral to

ethics committees

> and sober and quiet deliberation over the consequences of an

employee's

> refusal to act, the employer's determination to fire an employee

will almost always

> be upheld.

>

> And, in my opinion, that is as it should be. Put yourself in the

place of

> the employer. You dispatch Medic 2 to take a transfer of a

patient to another

> hospital where there's going to be a therapeutic abortion done.

Medic 2

> refuses to take the call. What does this do to your system? Is

it reasonable

> for Medic 2 to refuse? I think not.

>

> Would you hire an employee who tells you up front that he or she

will take

> all except certain categories of calls? Of course not. Are you

allowed to

> refuse employment to such people? Absolutely.

>

> So this whole question is absurd.

>

> And what about " sincerely-held religious beliefs? " What if I

sincerely

> believe in sacrifices of the first born son? You see, there's no

way to validate

> " sincerely - held religious beliefs. "

>

> I could say that I have a sincerely held belief that non-

caucasians are

> satanic individuals, and that I therefore cannot be involved in

their care. If I

> could simply swear that this was my " sincerely held belief " then I

could

> refuse to care for anybody that didn't fit my notion of

a " person. "

>

> That won't ever happen.

>

> Gene G.

>

> Gene G.

>

> >

> > In this case, an employer fired an employee for acting in

accordance with

> > her religious beliefs by refusing to become a participant in an

abortion.

> > Under federal employment discrimination laws, employers cannot

simply

> > terminate an employee who objects to participating in a medical

procedure

> > that is contrary to the employeeâ€™s religious beliefs.

> > If other arrangements were made to transport this patient to an

abortion

> > clinic, and the patient was not harmed as a result of the change

in

> > arrangements, then how can the employer justify the termination?

No one

> > should be punished for exercising their sincerely-held religious

beliefs.

> >

> > Just my opinion. Case was filed over two years ago, will be

interesting to

> > hear the outcome.

> >

> > For Some, There Is No Choice

> >

> > > For Some, There Is No Choice

> > >

> > > By Rob Stein

> > > Washington Post Staff Writer

> > > Sunday, July 16, 2006; A06

> > >

> > > When the dispatcher called, on knew this might

be the

> > > run she had feared. But it wasn't until her ambulance arrived

at the

> > > hospital and she saw the words " elective abortion " on the

patient's

> > > chart that she knew she had to make a choice.

> > >

> > > " I just got a sick feeling in my stomach, " said on, an

emergency

> > > medical technician from Channahon, Ill.

> > >

> > > on called her boss to say she could not transport the

patient to

> > > the other hospital where the procedure was scheduled.

> > >

> > > " I just knew I couldn't do it. I've never been for abortion --

I've

> > > always been against it, " on said. " I was brought up in a

> > > Christian home and always believed life was precious. "

> > >

> > > on's supervisor fired her on the spot and dispatched

another

> > > ambulance to transfer the distraught young patient.

> > >

> > > " It was a very long drive home, " said on, who sued the

ambulance

> > > company in May 2004, charging religious discrimination over

her 2003

> > > dismissal. " I pretty much cried all the way. I was very upset

and

> > > scared. "

> > >

> > > Many religious health workers find no conflict between their

beliefs

> > > and their jobs. But others describe what amounts to a sense of

siege,

> > > with the secular world increasingly demanding they capitulate

to doing

> > > procedures, prescribing pills or performing tasks that they

find

> > > morally reprehensible.

> > >

> > > Beginning in medical and nursing schools, some health workers

describe

> > > struggling over where to draw the line. Will they refuse to

perform an

> > > abortion or a sterilization, to fill a prescription for a

> > > morning-after pill or to pull the plug on a terminally ill

patient?

> > > Will they refer patients to health workers who will? Or is that

> > > tantamount to being complicit in an immoral act?

> > >

> > > Many will discuss their experiences only with a promise of

anonymity,

> > > fearing being reprimanded, fined, denied promotions or fired.

Often

> > > they will speak publicly only when they have new jobs.

> > >

> > > " I've run into major conflicts with my colleagues who don't

understand

> > > my belief system, " said Jan R. Hemstad, a Catholic

anesthesiologist in

> > > Yakima, Wash., who will not participate in

sterilizations. " I've had a

> > > colleague threaten to call the police to say I've abandoned a

patient

> > > who wanted an elective sterilization.

> > >

> > > Ultrasound technician Grant of New Richmond, Wis., was

fired by

> > > a Minneapolis clinic in 2002 after he prayed with a patient to

try to

> > > persuade her not to get an abortion.

> > >

> > > " I'm not a rabid pro-lifer, but I know what I believe, " said

Grant,

> > > also a pastor at a small Pentecostal church. " I was not

condemning in

> > > any way. But I had no choice but to speak my conscience. "

> > >

> > > Pharmacist Gene Herr was fired by a drugstore in Denton, Tex.,

in 2004

> > > after refusing to fill a rape victim's prescription for the

> > > morning-after pill.

> > >

> > > " This was the worst-case scenario, " Herr said. " This was the

hardest

> > > decision I ever made. The heinousness of a rape is a horrible

thing.

> > > But I don't think you should punish a child for the sins of the

> > > father. "

> > >

> > > Fertility specialist D. Madden, a Catholic, will treat

only

> > > married couples using their own sperm and eggs.

> > >

> > > " I believe the optimal circumstances for a child is to have a

mother

> > > and a father. They contribute different things to the

offspring, " said

> > > Madden, of the Presbyterian Hospital in Dallas. " I've sort of

picked

> > > my way through these ethical issues my whole life, and that's

one I

> > > haven't gotten comfortable with. "

> > >

> > > Pullicino, a Catholic neurologist from Newark, has

never

> > > agreed to withhold patients' food and fluids.

> > >

> > > " I've had many occasions where relatives of stroke victims

come up to

> > > me and say, 'She's suffering and wouldn't want to live in this

state,

> > > and we want to withdraw all care,' " Pullicino said. " I've had

to tell

> > > them, 'You'll have to find someone else.' I couldn't sleep at

night if

> > > I did some of those things. "

> > >

> > > He also refuses to work with embryonic stem cells. " I believe

it's

> > > destruction of a human life. It's wrong. "

> > >

> > > Family practitioners and obstetrician- Family practitioners

and obs

> > > from town to town and being shunned by colleagues because they

do not

> > > want to dispense birth control or morning-after pills or

perform

> > > sterilizations or abortions. Nurses and physician assistants

refuse to

> > > dispense the morning-after pill. Some doctors risk the ire of

> > > unmarried men after refusing to prescribe them Viagra.

> > >

> > > " I am convinced that God made human beings for man-to-woman

marriage,

> > > and that is where the sexual relationship should be, " said an

> > > evangelical Christian who works as an internist in

Baltimore. " I will

> > > not help foster that relationship outside of marriage. "

> > >

> > > ************ ******** ******** ******** ******** ****

> > >

> > > Since when do EMT's and Paramedics think they can decide who

gets

> > > service and who doesn't? Would this EMT refuse to provide care

for a

> > > doctor who performs abortions that was involved in a car

accident?

> > >

> > > Regardless of my personal stance, religious stance, moral

stance,

> > > whatever stance - on abortion - when I stepped up and accepted

a patch

> > > and got on an ambulance, I agreed to provide care to whomever

needs

> > > it. I support this manager firing this employee for refusing a

call.

> > >

> > > Mike :/

> > >

July 17, 2006

> I admit that I do not know all of the facts of this case, but I am having a

hard time understanding why an ambulance would be used for this purpose. Maybe

someone can shed some light on this for me.

If she was being treated in a hospital for one condition, and needed

services that hospital couldn't provide but another could, then it

would be a non-emergency transport typically handled by an ambulance

provider. That, or the hospital could have her sign out/discharge,

and go on her own to the other hospital, but there's more risk in

that... and Medicare/insurance will typically pay for transfers due to

a need for higher levels (or unavailable levels) of care.

> This brings me back to the question, what was the " emergency service "

associated with taking someone to an abortion clinic for an elective procedure?

Now we find ourselves in agreement. Although, to the point, she

wasn't going to an abortion clinic... she was being transferred to

between hospitals. Note that I said " ambulance service " earlier - I

am also of the belief that non-emergency transfers shouldn't be

categorized as EMS. That typically starts a large flame-war on the

list, because those providers that perform both services in their

community get their hackles up. I've done both, so I'm not

anti-transfer... not in the least. But I believe there is a

difference, and that when an emergency provider accepts a

non-emergency transfer, that is them filling two roles - EMS provider

and non-emergency transport provider - not because non-emergency

transfers are really any part or parcel EMERGENCY medical services.

Maybe we need a new name for the profession that accurately reflects

what EMT's and Paramedics do? Maybe just refer to all of it as

" paramedicine " ?

Mike

July 17, 2006

I still fail to see how the comparison is drawn between a life-saving blood

transfusion and an elective procedure. The EMT in this case did not deny

anyone emergency care.

If I ask my physician to perform an elective procedure on me that conflicts

with his religious beliefs, and he refuses, can I then demand that his

employer fire him? Why is this any different?

Does that mean other medical providers have more protection of their

religious beliefs than EMS providers? WHY?

If someone can explain to me why this elective abortion was an emergency,

than maybe it will make more sense to me. How often do all of you transport

patients to abortion clinics for elective abortions? Is this routine in

Texas EMS systems? I don't think that the slope is as slippery as others

are making it out to be.

As a side note.... " Do no harm " can have many meanings and interpretations.

Many believe that elective abortions constitute harm. If this is the

measuring stick that we are supposed to hold ourselves to, then who am I to

question your definition of harm? I also fail to see how refusing to

participate in an abortion is to " force their beliefs religious or otherwise

down [one's] throat. "

For Some, There Is No Choice

> >

> > > For Some, There Is No Choice

> > >

> > > By Rob Stein

> > > Washington Post Staff Writer

> > > Sunday, July 16, 2006; A06

> > >

> > > When the dispatcher called, on knew this might

be the

> > > run she had feared. But it wasn't until her ambulance arrived

at the

> > > hospital and she saw the words " elective abortion " on the

patient's

> > > chart that she knew she had to make a choice.

> > >

> > > " I just got a sick feeling in my stomach, " said on, an

emergency

> > > medical technician from Channahon, Ill.

> > >

> > > on called her boss to say she could not transport the

patient to

> > > the other hospital where the procedure was scheduled.

> > >

> > > " I just knew I couldn't do it. I've never been for abortion --

I've

> > > always been against it, " on said. " I was brought up in a

> > > Christian home and always believed life was precious. "

> > >

> > > on's supervisor fired her on the spot and dispatched

another

> > > ambulance to transfer the distraught young patient.

> > >

> > > " It was a very long drive home, " said on, who sued the

ambulance

> > > company in May 2004, charging religious discrimination over

her 2003

> > > dismissal. " I pretty much cried all the way. I was very upset

and

> > > scared. "

> > >

> > > Many religious health workers find no conflict between their

beliefs

> > > and their jobs. But others describe what amounts to a sense of

siege,

> > > with the secular world increasingly demanding they capitulate

to doing

> > > procedures, prescribing pills or performing tasks that they

find

> > > morally reprehensible.

> > >

> > > Beginning in medical and nursing schools, some health workers

describe

> > > struggling over where to draw the line. Will they refuse to

perform an

> > > abortion or a sterilization, to fill a prescription for a

> > > morning-after pill or to pull the plug on a terminally ill

patient?

> > > Will they refer patients to health workers who will? Or is that

> > > tantamount to being complicit in an immoral act?

> > >

> > > Many will discuss their experiences only with a promise of

anonymity,

> > > fearing being reprimanded, fined, denied promotions or fired.

Often

> > > they will speak publicly only when they have new jobs.

> > >

> > > " I've run into major conflicts with my colleagues who don't

understand

> > > my belief system, " said Jan R. Hemstad, a Catholic

anesthesiologist in

> > > Yakima, Wash., who will not participate in

sterilizations. " I've had a

> > > colleague threaten to call the police to say I've abandoned a

patient

> > > who wanted an elective sterilization.

> > >

> > > Ultrasound technician Grant of New Richmond, Wis., was

fired by

> > > a Minneapolis clinic in 2002 after he prayed with a patient to

try to

> > > persuade her not to get an abortion.

> > >

> > > " I'm not a rabid pro-lifer, but I know what I believe, " said

Grant,

> > > also a pastor at a small Pentecostal church. " I was not

condemning in

> > > any way. But I had no choice but to speak my conscience. "

> > >

> > > Pharmacist Gene Herr was fired by a drugstore in Denton, Tex.,

in 2004

> > > after refusing to fill a rape victim's prescription for the

> > > morning-after pill.

> > >

> > > " This was the worst-case scenario, " Herr said. " This was the

hardest

> > > decision I ever made. The heinousness of a rape is a horrible

thing.

> > > But I don't think you should punish a child for the sins of the

> > > father. "

> > >

> > > Fertility specialist D. Madden, a Catholic, will treat

only

> > > married couples using their own sperm and eggs.

> > >

> > > " I believe the optimal circumstances for a child is to have a

mother

> > > and a father. They contribute different things to the

offspring, " said

> > > Madden, of the Presbyterian Hospital in Dallas. " I've sort of

picked

> > > my way through these ethical issues my whole life, and that's

one I

> > > haven't gotten comfortable with. "

> > >

> > > Pullicino, a Catholic neurologist from Newark, has

never

> > > agreed to withhold patients' food and fluids.

> > >

> > > " I've had many occasions where relatives of stroke victims

come up to

> > > me and say, 'She's suffering and wouldn't want to live in this

state,

> > > and we want to withdraw all care,' " Pullicino said. " I've had

to tell

> > > them, 'You'll have to find someone else.' I couldn't sleep at

night if

> > > I did some of those things. "

> > >

> > > He also refuses to work with embryonic stem cells. " I believe

it's

> > > destruction of a human life. It's wrong. "

> > >

> > > Family practitioners and obstetrician- Family practitioners

and obs

> > > from town to town and being shunned by colleagues because they

do not

> > > want to dispense birth control or morning-after pills or

perform

> > > sterilizations or abortions. Nurses and physician assistants

refuse to

> > > dispense the morning-after pill. Some doctors risk the ire of

> > > unmarried men after refusing to prescribe them Viagra.

> > >

> > > " I am convinced that God made human beings for man-to-woman

marriage,

> > > and that is where the sexual relationship should be, " said an

> > > evangelical Christian who works as an internist in

Baltimore. " I will

> > > not help foster that relationship outside of marriage. "

> > >

> > > ************ ******** ******** ******** ******** ****

> > >

> > > Since when do EMT's and Paramedics think they can decide who

gets

> > > service and who doesn't? Would this EMT refuse to provide care

for a

> > > doctor who performs abortions that was involved in a car

accident?

> > >

> > > Regardless of my personal stance, religious stance, moral

stance,

> > > whatever stance - on abortion - when I stepped up and accepted

a patch

> > > and got on an ambulance, I agreed to provide care to whomever

needs

> > > it. I support this manager firing this employee for refusing a

call.

> > >

> > > Mike :/

> > >

July 17, 2006

If society views pregnancy as a " medical problem " that requires an ambulance

to transport the " patient " to the abortion clinic, then perhaps my line of

questioning is irrelevant.

Gene said... " Yes, he or she [the physician] can refuse unless it's an

emergency situation where the patient's outcome would be affected. But in

an emergency situation, he or she had better act for the patient's best

interests or be held liable for injury and damages. "

Help me understand this. If it is an emergency...why would the physician

transfer the patient to an elective abortion clinic? If this case was an

emergency, would the elective abortion clinic be the best place to care for

the patient? I think by virtue of the fact that " elective " abortion was the

patient's reason for transfer rules out the " emergency. " Why is it

different for the EMT?

For Some, There Is No Choice

>

> > For Some, There Is No Choice

> >

> > By Rob Stein

> > Washington Post Staff Writer

> > Sunday, July 16, 2006; A06

> >

> > When the dispatcher called, on knew this might be the

> > run she had feared. But it wasn't until her ambulance arrived at the

> > hospital and she saw the words " elective abortion " on the patient's

> > chart that she knew she had to make a choice.

> >

> > " I just got a sick feeling in my stomach, " said on, an emergency

> > medical technician from Channahon, Ill.

> >

> > on called her boss to say she could not transport the patient to

> > the other hospital where the procedure was scheduled.

> >

> > " I just knew I couldn't do it. I've never been for abortion -- I've

> > always been against it, " on said. " I was brought up in a

> > Christian home and always believed life was precious. "

> >

> > on's supervisor fired her on the spot and dispatched another

> > ambulance to transfer the distraught young patient.

> >

> > " It was a very long drive home, " said on, who sued the ambulance

> > company in May 2004, charging religious discrimination over her 2003

> > dismissal. " I pretty much cried all the way. I was very upset and

> > scared. "

> >

> > Many religious health workers find no conflict between their beliefs

> > and their jobs. But others describe what amounts to a sense of siege,

> > with the secular world increasingly demanding they capitulate to doing

> > procedures, prescribing pills or performing tasks that they find

> > morally reprehensible.

> >

> > Beginning in medical and nursing schools, some health workers describe

> > struggling over where to draw the line. Will they refuse to perform an

> > abortion or a sterilization, to fill a prescription for a

> > morning-after pill or to pull the plug on a terminally ill patient?

> > Will they refer patients to health workers who will? Or is that

> > tantamount to being complicit in an immoral act?

> >

> > Many will discuss their experiences only with a promise of anonymity,

> > fearing being reprimanded, fined, denied promotions or fired. Often

> > they will speak publicly only when they have new jobs.

> >

> > " I've run into major conflicts with my colleagues who don't understand

> > my belief system, " said Jan R. Hemstad, a Catholic anesthesiologist in

> > Yakima, Wash., who will not participate in sterilizations. " I've had a

> > colleague threaten to call the police to say I've abandoned a patient

> > who wanted an elective sterilization.

> >

> > Ultrasound technician Grant of New Richmond, Wis., was fired by

> > a Minneapolis clinic in 2002 after he prayed with a patient to try to

> > persuade her not to get an abortion.

> >

> > " I'm not a rabid pro-lifer, but I know what I believe, " said Grant,

> > also a pastor at a small Pentecostal church. " I was not condemning in

> > any way. But I had no choice but to speak my conscience. "

> >

> > Pharmacist Gene Herr was fired by a drugstore in Denton, Tex., in 2004

> > after refusing to fill a rape victim's prescription for the

> > morning-after pill.

> >

> > " This was the worst-case scenario, " Herr said. " This was the hardest

> > decision I ever made. The heinousness of a rape is a horrible thing.

> > But I don't think you should punish a child for the sins of the

> > father. "

> >

> > Fertility specialist D. Madden, a Catholic, will treat only

> > married couples using their own sperm and eggs.

> >

> > " I believe the optimal circumstances for a child is to have a mother

> > and a father. They contribute different things to the offspring, " said

> > Madden, of the Presbyterian Hospital in Dallas. " I've sort of picked

> > my way through these ethical issues my whole life, and that's one I

> > haven't gotten comfortable with. "

> >

> > Pullicino, a Catholic neurologist from Newark, has never

> > agreed to withhold patients' food and fluids.

> >

> > " I've had many occasions where relatives of stroke victims come up to

> > me and say, 'She's suffering and wouldn't want to live in this state,

> > and we want to withdraw all care,' " Pullicino said. " I've had to tell

> > them, 'You'll have to find someone else.' I couldn't sleep at night if

> > I did some of those things. "

> >

> > He also refuses to work with embryonic stem cells. " I believe it's

> > destruction of a human life. It's wrong. "

> >

> > Family practitioners and obstetrician- Family practitioners and obs

> > from town to town and being shunned by colleagues because they do not

> > want to dispense birth control or morning-after pills or perform

> > sterilizations or abortions. Nurses and physician assistants refuse to

> > dispense the morning-after pill. Some doctors risk the ire of

> > unmarried men after refusing to prescribe them Viagra.

> >

> > " I am convinced that God made human beings for man-to-woman marriage,

> > and that is where the sexual relationship should be, " said an

> > evangelical Christian who works as an internist in Baltimore. " I will

> > not help foster that relationship outside of marriage. "

> >

> > ************ ******** ******** ******** ******** ****

> >

> > Since when do EMT's and Paramedics think they can decide who gets

> > service and who doesn't? Would this EMT refuse to provide care for a

> > doctor who performs abortions that was involved in a car accident?

> >

> > Regardless of my personal stance, religious stance, moral stance,

> > whatever stance - on abortion - when I stepped up and accepted a patch

> > and got on an ambulance, I agreed to provide care to whomever needs

> > it. I support this manager firing this employee for refusing a call.

> >

> > Mike :/

> >

July 17, 2006

Then I guess the EMT in this case should have become a physician. Then she

would have been allowed to follow her religious beliefs.

Too bad EMTs and physicians are held to different standards regarding

religious beliefs and their practice.

> You want to hold tight to your religious beliefs to the point that you

> refuse to provide care for someone? Fine. Don't work in EMS.

snipped

> No, let's be clear. She was fired for refusing to transport a patient

> that the service had agreed to take. Had she been acting in her

> religious beliefs, she would either have not accepted the patch in the

> first place because she should have known she would have to interact

> with people and treat them in ways that she would find herself unable

> to do, religiously, or she should have informed her employer that she

> was not willing to perform for them on 100% of their calls for

> service.

>

>> Under federal employment discrimination laws, employers cannot simply

>> terminate an employee who objects to participating in a medical

>> procedure

>> that is contrary to the employee's religious beliefs.

>

> Correct, but you can fire them for refusing to do their job. She

> wasn't directly performing any service related to an abortion - she

> was transferring the patient to a facility full of medial providers

> who were able to provide the service per the patient's wishes, which

> were likely inline with the patient's moral, ethical and religious

> beliefs. Bottom line? She accepted a job knowing that this could

> come up, and when it did, she refused to do her job. Her employer

> can, and should, fire her for that.

>

>> If other arrangements were made to transport this patient to an abortion

>> clinic, and the patient was not harmed as a result of the change in

>> arrangements, then how can the employer justify the termination? No one

>> should be punished for exercising their sincerely-held religious

>> beliefs.

>

> Insubordination comes as a primary justification. And anyone who

> accepts a job in which their beliefs could be compromised, then

> complains when they choose to abandon the responsibilities of the job

> they accepted and agreed to do can and should be punished.

>

> You want to hold tight to your religious beliefs to the point that you

> refuse to provide care for someone? Fine. Don't work in EMS.

>

> Mike

>

July 17, 2006

Physicians maintain that....

" No physician or other professional personnel should be required to perform

an act violative of good medical judgment. Neither physician, hospital, nor

hospital personnel should be required to perform any act that violates

personally held moral principles. In these circumstances, good medical

practice requires only that the physician or OTHER PROFESSIONAL withdraw

from the case, SO LONG AS THE WITHDRAWAL IS CONSISTENT WITH GOOD MEDICAL

PRACTICE. "

If what you're saying is correct, then EMS is not a medical service at all,

but rather just a transport mechanism.

By this rationale...Everyone else is allowed to follow their religious

beliefs: physicians, pharmacists, nurses, etc. But EMS is different. They

just take people from one place to another.

This was the original point of my first post......EMS is being viewed as

nothing more than a taxi service. I guess we will all have to live with

that.

Re: For Some, There Is No Choice

> Not necessarily. The physician could only refuse if his refusal would

> not

> have caused harm to the patient. And EMS considerations and those of

> physicians are quite different. Take a look at the job descriptions.

>

> You're off base in trying to compare a physician's treatment

> determinations

> and an EMS employee's duty to carry out the job description. They're not

> the

> same.

>

> Physicians are independent practitioners; EMS people are not. Physicians

> are not routinely assigned to transport patients from one place to

> another, EMS

> people are.

>

> The EMS employee is not being asked to perform the procedure. She is

> only

> being asked to take the patient to the place where the procedure might be

> performed. The physician has the power to do the procedure or not do it.

> The

> EMS provider's not even close in terms of job description.

>

> Gene G.

>

> Gene G.

>

>>

>> Then I guess the EMT in this case should have become a physician. Then

>> she

>> would have been allowed to follow her religious beliefs.

>>

>> Too bad EMTs and physicians are held to different standards regarding

>> religious beliefs and their practice.

>>

>> >

>

July 17, 2006

While I'm not saying the employer was wrong for firing the medic, let me

throw out a comment to add a little chum to the water for this discussion.

If the medic took the pregnant women as a patient in her ambulance, then is

not the fetus/baby/womb resident also her patient along the same lines as

the woman carrying the baby? Seems as though this can develop into a

conflict when you do as the woman wanted for an elective termination of the

pregnancy and the medical charge to care for your patient. If I'm not

mistaken (and I'll admit that I do make mistakes on a regular basis), isn't

this part of the current hand-wringing by the physicians/lawyers/prosecutors

who are faced with a criminal charge for killing the fetus (as passed by the

state legislature for when a pregnant women is injured or killed and the

baby/fetus also dies) for performing the abortions? Where does treating the

fetus/baby fall under the medic's responsibility to care for the patient(s)

in the back of the ambulance in this type of situation.

Again, I'm not taking sides just trying to deepen the conversation.

Barry

Barry Sharp, MSHP, CHES

Exercise Coordinator

Community Preparedness Section

Texas Department of State Health Services

Phone: x2665

BlackBerry:

Fax:

Barry.Sharp@...

July 17, 2006

Refusing to transport a patient for ANY reason is wrong, no matter WHAT the

reason. She refused to perform her assigned duties, committing an act of

insubordination in the process. As Mike said, we do NOT have the luxury of

choosing the patients we deal with. She was NOT asked to assist with the

actual abortion procedure, simply to TRANSPORT the patient - no more, no

less.

What if she HAD been called to a collision, and found an " abortionist " lying

injured on the roadway? Would she have left him there to die? Pumped a

jumbo-sized air bolus into his IV line? Or would she have just simply

refused to provide him care?

I have NEVER agreed with the practice of " elective abortion " - I always

figured there were safer, easier, and cheaper PREEMPTIVE measures out there

- although I have NO RIGHT to force my beliefs on someone else, which is

what I think the EMT in question did, in a roundabout way. But would I

refuse to transport someone to or from such a procedure? No, because I do

not have that luxury.

I personally loath pedophiles and wife beaters, but I have no right to

refuse them the medical care they require, whether it is full ACLS or just a

ride to the hospital. I am disgusted by people who drink to the point of

intoxication, and then drive down the highway and destroy innocent lives in

an alcohol-induced collision, but I am required to transport them, and give

them the SAME exact quality of care as I provide for their innocent victims.

To allow my religious, moral, or personal beliefs to color my care would be

one of the major reasons for me to find a new line of work. I would expect

the same treatment if I were to do what she did.

Barry McClung, EMT-P

July 17, 2006

Mr. ,

I totally agree with your assessment on this issue. If you accept the patch

you must be willing to treat ANY and EVERY one. Like in my world, I'd begin

immediate treatment to a suspect that I just had to shoot in self defense

should, God forbid, the situation ever comes up. In EMS it is one's duty to

treat the sick and injured, reguardless of your personal feelings toward

them or their religon, race, creed or their beliefs.

Jim H.

EMT-B/Security Officer

Dallas County SEM

>

>Reply-To: texasems-l

>To: TexasEMS-L <texasems-l >, Paramedicine

>Subject: For Some, There Is No Choice

>Date: Sun, 16 Jul 2006 23:17:31 -0500

>

>For Some, There Is No Choice

>

>By Rob Stein

>Washington Post Staff Writer

>Sunday, July 16, 2006; A06

>

>When the dispatcher called, on knew this might be the

>run she had feared. But it wasn't until her ambulance arrived at the

>hospital and she saw the words " elective abortion " on the patient's

>chart that she knew she had to make a choice.

>

> " I just got a sick feeling in my stomach, " said on, an emergency

>medical technician from Channahon, Ill.

>

>on called her boss to say she could not transport the patient to

>the other hospital where the procedure was scheduled.

>

> " I just knew I couldn't do it. I've never been for abortion -- I've

>always been against it, " on said. " I was brought up in a

>Christian home and always believed life was precious. "

>

>on's supervisor fired her on the spot and dispatched another

>ambulance to transfer the distraught young patient.

>

> " It was a very long drive home, " said on, who sued the ambulance

>company in May 2004, charging religious discrimination over her 2003

>dismissal. " I pretty much cried all the way. I was very upset and

>scared. "

>

>Many religious health workers find no conflict between their beliefs

>and their jobs. But others describe what amounts to a sense of siege,

>with the secular world increasingly demanding they capitulate to doing

>procedures, prescribing pills or performing tasks that they find

>morally reprehensible.

>

>Beginning in medical and nursing schools, some health workers describe

>struggling over where to draw the line. Will they refuse to perform an

>abortion or a sterilization, to fill a prescription for a

>morning-after pill or to pull the plug on a terminally ill patient?

>Will they refer patients to health workers who will? Or is that

>tantamount to being complicit in an immoral act?

>

>Many will discuss their experiences only with a promise of anonymity,

>fearing being reprimanded, fined, denied promotions or fired. Often

>they will speak publicly only when they have new jobs.

>

> " I've run into major conflicts with my colleagues who don't understand

>my belief system, " said Jan R. Hemstad, a Catholic anesthesiologist in

>Yakima, Wash., who will not participate in sterilizations. " I've had a

>colleague threaten to call the police to say I've abandoned a patient

>who wanted an elective sterilization. "

>

>Ultrasound technician Grant of New Richmond, Wis., was fired by

>a Minneapolis clinic in 2002 after he prayed with a patient to try to

>persuade her not to get an abortion.

>

> " I'm not a rabid pro-lifer, but I know what I believe, " said Grant,

>also a pastor at a small Pentecostal church. " I was not condemning in

>any way. But I had no choice but to speak my conscience. "

>

>Pharmacist Gene Herr was fired by a drugstore in Denton, Tex., in 2004

>after refusing to fill a rape victim's prescription for the

>morning-after pill.

>

> " This was the worst-case scenario, " Herr said. " This was the hardest

>decision I ever made. The heinousness of a rape is a horrible thing.

>But I don't think you should punish a child for the sins of the

>father. "

>

>Fertility specialist D. Madden, a Catholic, will treat only

>married couples using their own sperm and eggs.

>

> " I believe the optimal circumstances for a child is to have a mother

>and a father. They contribute different things to the offspring, " said

>Madden, of the Presbyterian Hospital in Dallas. " I've sort of picked

>my way through these ethical issues my whole life, and that's one I

>haven't gotten comfortable with. "

>

> Pullicino, a Catholic neurologist from Newark, has never

>agreed to withhold patients' food and fluids.

>

> " I've had many occasions where relatives of stroke victims come up to

>me and say, 'She's suffering and wouldn't want to live in this state,

>and we want to withdraw all care,' " Pullicino said. " I've had to tell

>them, 'You'll have to find someone else.' I couldn't sleep at night if

>I did some of those things. "

>

>He also refuses to work with embryonic stem cells. " I believe it's

>destruction of a human life. It's wrong. "

>

>Family practitioners and obstetrician-gynecologists describe moving

>from town to town and being shunned by colleagues because they do not

>want to dispense birth control or morning-after pills or perform

>sterilizations or abortions. Nurses and physician assistants refuse to

>dispense the morning-after pill. Some doctors risk the ire of

>unmarried men after refusing to prescribe them Viagra.

>

> " I am convinced that God made human beings for man-to-woman marriage,

>and that is where the sexual relationship should be, " said an

>evangelical Christian who works as an internist in Baltimore. " I will

>not help foster that relationship outside of marriage. "

>

>*****************************************************

>

>Since when do EMT's and Paramedics think they can decide who gets

>service and who doesn't? Would this EMT refuse to provide care for a

>doctor who performs abortions that was involved in a car accident?

>

>Regardless of my personal stance, religious stance, moral stance,

>whatever stance - on abortion - when I stepped up and accepted a patch

>and got on an ambulance, I agreed to provide care to whomever needs

>it. I support this manager firing this employee for refusing a call.

>

>Mike :/

>

July 17, 2006

This will be my last comment on this matter.

For those who wish to test the system, lawyers are available. You'll

quickly find that nobody will want to take your case if you're the fired

employee

unless you've got megabucks to fund the suit. Set aside $100,000 or so to

start. Of course, there's always the ACLU if you can't afford a private

lawyer.

It's easy to debate what the law should or should not be. It's often hard

to find out just exactly what it is without going through the system to find

out. Similar factual situations often have opposite outcomes in the court

system. One nuanced fact can make all the difference.

I haven't researched the case law; I don't have time to and nobody's

paying me for it. My comments have been based upon what common sense and

knowledge of the law I have left, plus a large dose of experience.

My final thoughts are that people who have serious problems in serving some

segment of the public while performing a job that deals with the public might

do well to seek alternative employment.

It's nice to think that employers are so enlightened and sensitive that

they're ready to bend over backward to accommodate the personal preferences of

their employees. I haven't run into any of them in my life, but I've lived in

the country mostly where folks just get up, go to work, do the job, and leave

their personal foibles behind.

Speaking of which, tomorrow morning will be here too soon. Night.

Gene G.

>

> Gene,

>

> A couple of points...courts have ruled repeatedly about " strongly held

> religious beliefs " and when employers " in the moment " fired someone because

they

> refused to do a job for religious reasons...and this wasn't a " i'm doing it to

> get outta work " but was an honest religious belief and honoring such request

> was a prudent decision, the employer has very frequently been found at

> fault...you cannot discriminate against someone because of a religious

belief...no

> matter the line of work.

>

> Now all that to say, I too believe the courts will side with the employer on

> this case...not because of religion...but because the employer would have

> fired ANYONE " who refused a call for any reason " other than life safety. If

the

> employer has allowed other people to refuse transfers for other

> reasons...than the precedent is there to allow it here...and this is where it

gets dicey

> in some systems that do non-emergency and the dispatchers friend always seems

> to have a reason for not running the call....well then a reason is a reason

> and company policy (official OR unofficial) will prevail.

>

> Now, as one who employs paramedics and emt's...I will tell you I don't know

> if I would have fired this person. I strive constantly to get my paramedics

> and emt's to THINK and make decisions based upon all the factors of the call.

> We are a community based EMS organization and our community interaction is

> key...and I believe that by allowing our medics to think and strive for doing

> the best for each and every person (themselves included) then sometimes our

> crews will make inappropriate decisions or " not the best " decision. Now, if

> this were to occur in my system, conversations (maybe discipline) and some

long

> conversations may have allowed us to salvage an employee who maybe just

> needed some input and guidance much like the conversation that has been on

this

> list over the last 24 hours.

>

> I believe you have to take both the good and bad when you allow folks to

> develop independant thought processes striving to care for all our

customers...

> I believe you have to take both the good and bad when you allow folks to

> develop independant thought processes striving to care for all our

customers...<

> wbr>and if I get a " refusal " to transport a non-emergency patient from

> facility to facility on a rare occasion because of a mis-guided thought

process to

> continue to get care such as cleaning up an elderly person who slipped in

> their poop and fell w/o injury, take a BP and sit and talk with a " scared "

> patient who is still adjusting to sleeping in an empty bed after 55+

years...or

> like last Thursday, finding an elderly patient who can't drive and her

> handicapped grand-daughter home alone...after grandma slipped and fell w/o

> injury...and running down to the corner to buy them KFC with the fixin's

because grandma

> spilt lunch on the

>

> Those are my thoughts...I don't think you can encourage folks to think for

> themselves.. Those are my thoughts...I don't

>

> Dudley

>

> Re: For Some, There Is No Choice

>

> I understand what you're saying. However, the court will look at the

> overall picture and decide what the impact of a decision that allows an

> individual

> EMS certificant to pick and choose the patients he or she will care for

> might

> be. I suspect that the court will find that to allow an employee to dictate

> which calls she will respond to would impose an unreasonable constraint upon

> the employer.

>

> The federal law that you are talking about is not about emergency services.

> So there are factual differences in the cases.

>

> The anti-discrimination laws almost always bend to the requirements of the

> moment: meaning that when time doesn't allow for referral to ethics

> committees

> and sober and quiet deliberation over the consequences of an employee's

> refusal to act, the employer's determination to fire an employee will almost

> always

> be upheld.

>

> And, in my opinion, that is as it should be. Put yourself in the place of

> the employer. You dispatch Medic 2 to take a transfer of a patient to

> another

> hospital where there's going to be a therapeutic abortion done. Medic 2

> refuses to take the call. What does this do to your system? Is it reasonable

> for Medic 2 to refuse? I think not.

>

> Would you hire an employee who tells you up front that he or she will take

> all except certain categories of calls? Of course not. Are you allowed to

> refuse employment to such people? Absolutely.

>

> So this whole question is absurd.

>

> And what about " sincerely-held religious beliefs? " What if I sincerely

> believe in sacrifices of the first born son? You see, there's no way to

> validate

> " sincerely - held religious beliefs. "

>

> I could say that I have a sincerely held belief that non-caucasians are

> satanic individuals, and that I therefore cannot be involved in their care.

> If I

> could simply swear that this was my " sincerely held belief " then I could

> refuse to care for anybody that didn't fit my notion of a " person. "

>

> That won't ever happen.

>

> Gene G.

>

> Gene G.

>

> >

> > In this case, an employer fired an employee for acting in accordance with

> > her religious beliefs by refusing to become a participant in an abortion.

> > Under federal employment discrimination laws, employers cannot simply

> > terminate an employee who objects to participating in a medical procedure

> > that is contrary to the employeeâ€™s religious beliefs.

> > If other arrangements were made to transport this patient to an abortion

> > clinic, and the patient was not harmed as a result of the change in

> > arrangements, then how can the employer justify the termination? No one

> > should be punished for exercising their sincerely-held religious beliefs.

> >

> > Just my opinion. Case was filed over two years ago, will be interesting to

> > hear the outcome.

> >

> > For Some, There Is No Choice

> >

> > > For Some, There Is No Choice

> > >

> > > By Rob Stein

> > > Washington Post Staff Writer

> > > Sunday, July 16, 2006; A06

> > >

> > > When the dispatcher called, on knew this might be the

> > > run she had feared. But it wasn't until her ambulance arrived at the

> > > hospital and she saw the words " elective abortion " on the patient's

> > > chart that she knew she had to make a choice.

> > >

> > > " I just got a sick feeling in my stomach, " said on, an emergency

> > > medical technician from Channahon, Ill.

> > >

> > > on called her boss to say she could not transport the patient to

> > > the other hospital where the procedure was scheduled.

> > >

> > > " I just knew I couldn't do it. I've never been for abortion -- I've

> > > always been against it, " on said. " I was brought up in a

> > > Christian home and always believed life was precious. "

> > >

> > > on's supervisor fired her on the spot and dispatched another

> > > ambulance to transfer the distraught young patient.

> > >

> > > " It was a very long drive home, " said on, who sued the ambulance

> > > company in May 2004, charging religious discrimination over her 2003

> > > dismissal. " I pretty much cried all the way. I was very upset and

> > > scared. "

> > >

> > > Many religious health workers find no conflict between their beliefs

> > > and their jobs. But others describe what amounts to a sense of siege,

> > > with the secular world increasingly demanding they capitulate to doing

> > > procedures, prescribing pills or performing tasks that they find

> > > morally reprehensible.

> > >

> > > Beginning in medical and nursing schools, some health workers describe

> > > struggling over where to draw the line. Will they refuse to perform an

> > > abortion or a sterilization, to fill a prescription for a

> > > morning-after pill or to pull the plug on a terminally ill patient?

> > > Will they refer patients to health workers who will? Or is that

> > > tantamount to being complicit in an immoral act?

> > >

> > > Many will discuss their experiences only with a promise of anonymity,

> > > fearing being reprimanded, fined, denied promotions or fired. Often

> > > they will speak publicly only when they have new jobs.

> > >

> > > " I've run into major conflicts with my colleagues who don't understand

> > > my belief system, " said Jan R. Hemstad, a Catholic anesthesiologist in

> > > Yakima, Wash., who will not participate in sterilizations. " I've had a

> > > colleague threaten to call the police to say I've abandoned a patient

> > > who wanted an elective sterilization.

> > >

> > > Ultrasound technician Grant of New Richmond, Wis., was fired by

> > > a Minneapolis clinic in 2002 after he prayed with a patient to try to

> > > persuade her not to get an abortion.

> > >

> > > " I'm not a rabid pro-lifer, but I know what I believe, " said Grant,

> > > also a pastor at a small Pentecostal church. " I was not condemning in

> > > any way. But I had no choice but to speak my conscience. "

> > >

> > > Pharmacist Gene Herr was fired by a drugstore in Denton, Tex., in 2004

> > > after refusing to fill a rape victim's prescription for the

> > > morning-after pill.

> > >

> > > " This was the worst-case scenario, " Herr said. " This was the hardest

> > > decision I ever made. The heinousness of a rape is a horrible thing.

> > > But I don't think you should punish a child for the sins of the

> > > father. "

> > >

> > > Fertility specialist D. Madden, a Catholic, will treat only

> > > married couples using their own sperm and eggs.

> > >

> > > " I believe the optimal circumstances for a child is to have a mother

> > > and a father. They contribute different things to the offspring, " said

> > > Madden, of the Presbyterian Hospital in Dallas. " I've sort of picked

> > > my way through these ethical issues my whole life, and that's one I

> > > haven't gotten comfortable with. "

> > >

> > > Pullicino, a Catholic neurologist from Newark, has never

> > > agreed to withhold patients' food and fluids.

> > >

> > > " I've had many occasions where relatives of stroke victims come up to

> > > me and say, 'She's suffering and wouldn't want to live in this state,

> > > and we want to withdraw all care,' " Pullicino said. " I've had to tell

> > > them, 'You'll have to find someone else.' I couldn't sleep at night if

> > > I did some of those things. "

> > >

> > > He also refuses to work with embryonic stem cells. " I believe it's

> > > destruction of a human life. It's wrong. "

> > >

> > > Family practitioners and obstetrician- Family practitioners and obs

> > > from town to town and being shunned by colleagues because they do not

> > > want to dispense birth control or morning-after pills or perform

> > > sterilizations or abortions. Nurses and physician assistants refuse to

> > > dispense the morning-after pill. Some doctors risk the ire of

> > > unmarried men after refusing to prescribe them Viagra.

> > >

> > > " I am convinced that God made human beings for man-to-woman marriage,

> > > and that is where the sexual relationship should be, " said an

> > > evangelical Christian who works as an internist in Baltimore. " I will

> > > not help foster that relationship outside of marriage. "

> > >

> > > ************ ******** ******** ******** ******** ****

> > >

> > > Since when do EMT's and Paramedics think they can decide who gets

> > > service and who doesn't? Would this EMT refuse to provide care for a

> > > doctor who performs abortions that was involved in a car accident?

> > >

> > > Regardless of my personal stance, religious stance, moral stance,

> > > whatever stance - on abortion - when I stepped up and accepted a patch

> > > and got on an ambulance, I agreed to provide care to whomever needs

> > > it. I support this manager firing this employee for refusing a call.

> > >

> > > Mike :/

> > >

July 17, 2006

Gene,

A couple of points...courts have ruled repeatedly about " strongly held

religious beliefs " and when employers " in the moment " fired someone because they

refused to do a job for religious reasons...and this wasn't a " i'm doing it to

get outta work " but was an honest religious belief and honoring such request was

a prudent decision, the employer has very frequently been found at fault...you

cannot discriminate against someone because of a religious belief...no matter

the line of work.

Now all that to say, I too believe the courts will side with the employer on

this case...not because of religion...but because the employer would have fired

ANYONE " who refused a call for any reason " other than life safety. If the

employer has allowed other people to refuse transfers for other reasons...than

the precedent is there to allow it here...and this is where it gets dicey in

some systems that do non-emergency and the dispatchers friend always seems to

have a reason for not running the call....well then a reason is a reason and

company policy (official OR unofficial) will prevail.

Now, as one who employs paramedics and emt's...I will tell you I don't know if

I would have fired this person. I strive constantly to get my paramedics and

emt's to THINK and make decisions based upon all the factors of the call. We are

a community based EMS organization and our community interaction is key...and I

believe that by allowing our medics to think and strive for doing the best for

each and every person (themselves included) then sometimes our crews will make

inappropriate decisions or " not the best " decision. Now, if this were to occur

in my system, conversations (maybe discipline) and some long conversations may

have allowed us to salvage an employee who maybe just needed some input and

guidance much like the conversation that has been on this list over the last 24

hours.

I believe you have to take both the good and bad when you allow folks to

develop independant thought processes striving to care for all our

customers...and if I get a " refusal " to transport a non-emergency patient from

facility to facility on a rare occasion because of a mis-guided thought process

to continue to get care such as cleaning up an elderly person who slipped in

their poop and fell w/o injury, take a BP and sit and talk with a " scared "

patient who is still adjusting to sleeping in an empty bed after 55+ years...or

like last Thursday, finding an elderly patient who can't drive and her

handicapped grand-daughter home alone...after grandma slipped and fell w/o

injury...and running down to the corner to buy them KFC with the fixin's because

grandma spilt lunch on the floor when she fell and there is nothing else to

fix....and the kids won't be home until after work...then I will take the bad

decision any day of the week....

Those are my thoughts...I don't think you can encourage folks to think for

themselves...but only in certain situations...

Dudley

Re: For Some, There Is No Choice

I understand what you're saying. However, the court will look at the

overall picture and decide what the impact of a decision that allows an

individual

EMS certificant to pick and choose the patients he or she will care for might

be. I suspect that the court will find that to allow an employee to dictate

which calls she will respond to would impose an unreasonable constraint upon

the employer.

The federal law that you are talking about is not about emergency services.

So there are factual differences in the cases.

The anti-discrimination laws almost always bend to the requirements of the

moment: meaning that when time doesn't allow for referral to ethics committees

and sober and quiet deliberation over the consequences of an employee's

refusal to act, the employer's determination to fire an employee will almost

always

be upheld.

And, in my opinion, that is as it should be. Put yourself in the place of

the employer. You dispatch Medic 2 to take a transfer of a patient to another

hospital where there's going to be a therapeutic abortion done. Medic 2

refuses to take the call. What does this do to your system? Is it reasonable

for Medic 2 to refuse? I think not.

Would you hire an employee who tells you up front that he or she will take

all except certain categories of calls? Of course not. Are you allowed to

refuse employment to such people? Absolutely.

So this whole question is absurd.

And what about " sincerely-held religious beliefs? " What if I sincerely

believe in sacrifices of the first born son? You see, there's no way to

validate

" sincerely - held religious beliefs. "

I could say that I have a sincerely held belief that non-caucasians are

satanic individuals, and that I therefore cannot be involved in their care. If

I

could simply swear that this was my " sincerely held belief " then I could

refuse to care for anybody that didn't fit my notion of a " person. "

That won't ever happen.

Gene G.

>

> In this case, an employer fired an employee for acting in accordance with

> her religious beliefs by refusing to become a participant in an abortion.

> Under federal employment discrimination laws, employers cannot simply

> terminate an employee who objects to participating in a medical procedure

> that is contrary to the employeeâ€™s religious beliefs.

> If other arrangements were made to transport this patient to an abortion

> clinic, and the patient was not harmed as a result of the change in

> arrangements, then how can the employer justify the termination? No one

> should be punished for exercising their sincerely-held religious beliefs.

>

> Just my opinion. Case was filed over two years ago, will be interesting to

> hear the outcome.

>

> For Some, There Is No Choice

>

> > For Some, There Is No Choice

> >

> > By Rob Stein

> > Washington Post Staff Writer

> > Sunday, July 16, 2006; A06

> >

> > When the dispatcher called, on knew this might be the

> > run she had feared. But it wasn't until her ambulance arrived at the

> > hospital and she saw the words " elective abortion " on the patient's

> > chart that she knew she had to make a choice.

> >

> > " I just got a sick feeling in my stomach, " said on, an emergency

> > medical technician from Channahon, Ill.

> >

> > on called her boss to say she could not transport the patient to

> > the other hospital where the procedure was scheduled.

> >

> > " I just knew I couldn't do it. I've never been for abortion -- I've

> > always been against it, " on said. " I was brought up in a

> > Christian home and always believed life was precious. "

> >

> > on's supervisor fired her on the spot and dispatched another

> > ambulance to transfer the distraught young patient.

> >

> > " It was a very long drive home, " said on, who sued the ambulance

> > company in May 2004, charging religious discrimination over her 2003

> > dismissal. " I pretty much cried all the way. I was very upset and

> > scared. "

> >

> > Many religious health workers find no conflict between their beliefs

> > and their jobs. But others describe what amounts to a sense of siege,

> > with the secular world increasingly demanding they capitulate to doing

> > procedures, prescribing pills or performing tasks that they find

> > morally reprehensible.

> >

> > Beginning in medical and nursing schools, some health workers describe

> > struggling over where to draw the line. Will they refuse to perform an

> > abortion or a sterilization, to fill a prescription for a

> > morning-after pill or to pull the plug on a terminally ill patient?

> > Will they refer patients to health workers who will? Or is that

> > tantamount to being complicit in an immoral act?

> >

> > Many will discuss their experiences only with a promise of anonymity,

> > fearing being reprimanded, fined, denied promotions or fired. Often

> > they will speak publicly only when they have new jobs.

> >

> > " I've run into major conflicts with my colleagues who don't understand

> > my belief system, " said Jan R. Hemstad, a Catholic anesthesiologist in

> > Yakima, Wash., who will not participate in sterilizations. " I've had a

> > colleague threaten to call the police to say I've abandoned a patient

> > who wanted an elective sterilization.

> >

> > Ultrasound technician Grant of New Richmond, Wis., was fired by

> > a Minneapolis clinic in 2002 after he prayed with a patient to try to

> > persuade her not to get an abortion.

> >

> > " I'm not a rabid pro-lifer, but I know what I believe, " said Grant,

> > also a pastor at a small Pentecostal church. " I was not condemning in

> > any way. But I had no choice but to speak my conscience. "

> >

> > Pharmacist Gene Herr was fired by a drugstore in Denton, Tex., in 2004

> > after refusing to fill a rape victim's prescription for the

> > morning-after pill.

> >

> > " This was the worst-case scenario, " Herr said. " This was the hardest

> > decision I ever made. The heinousness of a rape is a horrible thing.

> > But I don't think you should punish a child for the sins of the

> > father. "

> >

> > Fertility specialist D. Madden, a Catholic, will treat only

> > married couples using their own sperm and eggs.

> >

> > " I believe the optimal circumstances for a child is to have a mother

> > and a father. They contribute different things to the offspring, " said

> > Madden, of the Presbyterian Hospital in Dallas. " I've sort of picked

> > my way through these ethical issues my whole life, and that's one I

> > haven't gotten comfortable with. "

> >

> > Pullicino, a Catholic neurologist from Newark, has never

> > agreed to withhold patients' food and fluids.

> >

> > " I've had many occasions where relatives of stroke victims come up to

> > me and say, 'She's suffering and wouldn't want to live in this state,

> > and we want to withdraw all care,' " Pullicino said. " I've had to tell

> > them, 'You'll have to find someone else.' I couldn't sleep at night if

> > I did some of those things. "

> >

> > He also refuses to work with embryonic stem cells. " I believe it's

> > destruction of a human life. It's wrong. "

> >

> > Family practitioners and obstetrician- Family practitioners and obs

> > from town to town and being shunned by colleagues because they do not

> > want to dispense birth control or morning-after pills or perform

> > sterilizations or abortions. Nurses and physician assistants refuse to

> > dispense the morning-after pill. Some doctors risk the ire of

> > unmarried men after refusing to prescribe them Viagra.

> >

> > " I am convinced that God made human beings for man-to-woman marriage,

> > and that is where the sexual relationship should be, " said an

> > evangelical Christian who works as an internist in Baltimore. " I will

> > not help foster that relationship outside of marriage. "

> >

> > ************ ******** ******** ******** ******** ****

> >

> > Since when do EMT's and Paramedics think they can decide who gets

> > service and who doesn't? Would this EMT refuse to provide care for a

> > doctor who performs abortions that was involved in a car accident?

> >

> > Regardless of my personal stance, religious stance, moral stance,

> > whatever stance - on abortion - when I stepped up and accepted a patch

> > and got on an ambulance, I agreed to provide care to whomever needs

> > it. I support this manager firing this employee for refusing a call.

> >

> > Mike :/

> >

July 18, 2006

This is my first post but I felt the need to speak my mind. I would

have to agree with Mr.M I have never and will never refuse a

call no matter my moral stand point.

Every patient deserves a medic who's major concern is there Pt. Not

there religious stance. We all got into this field to treat people

in need with the up most respect no matter the call.

I belive the medic should have been fired. If you are unable to

preform your job then maybe it's time to find a new job. We are not

here to judge. I would have fired the medic on the spot. If you are

a JW do you refuse to TX a PT. who might require a blood transfsion

to save there life? If we start to refuse calls when does it stop.

Franco

>

> *****************************************************

>

> Since when do EMT's and Paramedics think they can decide who gets

> service and who doesn't? Would this EMT refuse to provide care

for a

> doctor who performs abortions that was involved in a car accident?

>

> Regardless of my personal stance, religious stance, moral stance,

> whatever stance - on abortion - when I stepped up and accepted a

patch

> and got on an ambulance, I agreed to provide care to whomever needs

> it. I support this manager firing this employee for refusing a

call.

>

> Mike :/

**********************************************************

>

July 18, 2006

They should not get into the feild of EMS, or medical at all!! Treat

everone the same!!

-- In texasems-l , " "

wrote:

>

> This is my first post but I felt the need to speak my mind. I would

> have to agree with Mr.M I have never and will never refuse a

> call no matter my moral stand point.

>

> Every patient deserves a medic who's major concern is there Pt. Not

> there religious stance. We all got into this field to treat people

> in need with the up most respect no matter the call.

>

> I belive the medic should have been fired. If you are unable to

> preform your job then maybe it's time to find a new job. We are not

> here to judge. I would have fired the medic on the spot. If you

are

> a JW do you refuse to TX a PT. who might require a blood transfsion

> to save there life? If we start to refuse calls when does it stop.

>

> Franco

>

> >

> > *****************************************************

> >

> > Since when do EMT's and Paramedics think they can decide who gets

> > service and who doesn't? Would this EMT refuse to provide care

> for a

> > doctor who performs abortions that was involved in a car

accident?

> >

> > Regardless of my personal stance, religious stance, moral stance,

> > whatever stance - on abortion - when I stepped up and accepted a

> patch

> > and got on an ambulance, I agreed to provide care to whomever

needs

> > it. I support this manager firing this employee for refusing a

> call.

> >

> > Mike :/

>

> **********************************************************

> >

>

July 21, 2006

In a message dated 17-Jul-06 00:29:29 Central Daylight Time,

wegandy1938@... writes:

There are times when people need to be true to themselves and take

responsibility for their actions. If an EMS provider cannot in good

conscience care

for and carry out the transports of all patients that fall within their

care,

then perhaps that person ought not be in EMS. I have not known any

physicians

who wouldn't care for a certain kind of patient, even when they disagreed

with

that patient's lifestyle or religious philosophy. I'm sure there are some,

but unless they can step aside and allow another physician to step in, they

are going to be liable for any injury that might occur to a patient they

refused

to treat.

I'm catching up after a couple of days on the road again... I do know of

several situations where physicians have transferred care to an associate or

competitor when the original physician could not in good conscious provide the

care needed or requested by the patient, WHEN THE CARE WAS LAWFUL.

In many cases, physicians and nurses who have this kind of objector status

do have an out that a street medic does not...they can choose to associate

themselves with facilities who follow the same kind of code that they profess

to

espouse...not something always possible for a medic.

ck

S. Krin, DO FAAFP

July 21, 2006

Dr. Krin makes some good points. I would be less appalled at the refusals

of a medic to take a call that involved a patient or procedure that s/he had

some sort of moral allergy to, if there were reasonable alternatives.

But in most EMS systems, staffing is minimal, and you're worked to death

(courtesy of SSM) and there just isn't the opportunity to have a nice discussion

with your company's ETHICS MANAGER (ha ha ha) and have her or him say, " We

fully understand your difficulty with this assignment, and we support your

rights

to adhere to your personal moral principles. So just don't worry about it.

We'll call in another crew to take this call, and you can take the rest of

the day off, with pay, to recover from the stress that we put you through by

even suggesting that you transport a patient for a procedure that offends your

moral sensitivities. And we are going to write you a formal letter of

apology which will go into your personnel file, and also we're giving you a $150

voucher for dinner for yourself and a guest at the best restaurant in town.

Sincerely, we apologize for putting you through 17 minutes of hell. "

Um, Toto, I don't think we're in Kansas anymore.

GG

>

> In a message dated 17-Jul-06 00:29:29 Central Daylight Time,

> wegandy1938@wegandy writes:

>

> There are times when people need to be true to themselves and take

> responsibility for their actions. If an EMS provider cannot in good

> conscience care

> for and carry out the transports of all patients that fall within their

> care,

> then perhaps that person ought not be in EMS. I have not known any

> physicians

> who wouldn't care for a certain kind of patient, even when they disagreed

> with

> that patient's lifestyle or religious philosophy. I'm sure there are some,

> but unless they can step aside and allow another physician to step in, they

> are going to be liable for any injury that might occur to a patient they

> refused

> to treat.

>

> I'm catching up after a couple of days on the road again... I do know of

> several situations where physicians have transferred care to an associate or

> competitor when the original physician could not in good conscious provide

> the

> care needed or requested by the patient, WHEN THE CARE WAS LAWFUL.

>

> In many cases, physicians and nurses who have this kind of objector status

> do have an out that a street medic does not...they can choose to associate

> themselves with facilities who follow the same kind of code that they

> profess to

> espouse...not something always possible for a medic.

>

> ck

>

> S. Krin, DO FAAFP

>

Sign In

For Some, There Is No Choice

Recommended Posts

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Guest guest

Link to comment

Share on other sites

Join the conversation

Activity